Individual provider Active NPI

Victor M Perez, MD

  • Psychiatry Physician
  • Hagatna, GU
National Provider Identifier
1114107109
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M000893 Issued in GU
Practice address
238 Archbishop Flores St
Suite 403C
Hagatna, GU 96910-5206
Phone
(671) 477-4619
Fax
(671) 477-4619
NPI assigned
Nov 7, 2007
Last updated
Mar 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M000893 GU Primary
Psychiatry Physician 2084P0800X M893 GU

Addresses

Primary practice location

238 Archbishop Flores St
Suite 403C
Hagatna, GU 96910-5206

Mailing address

114 Etton CT
Suite 403C
Sinajana, GU 96910-3224
Phone (671) 988-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170412001486 GU Order and Referring Only - PsychiatryPractitioner - Psychiatry 7618253329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M000893GUMDPsychiatry Physician
M893GUMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1114107109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ETTON CT",
            "address_2": "SUITE 403C",
            "city": "SINAJANA",
            "state": "GU",
            "postal_code": "969103224",
            "telephone_number": "671-988-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ARCHBISHOP FLORES ST",
            "address_2": "SUITE 403C",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105206",
            "telephone_number": "671-477-4619",
            "fax_number": "671-477-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "VICTOR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GU",
            "license": "M000893",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GU",
            "license": "M893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagatna, GU

Sources for this page

Verify at the official NPI Registry.