Individual provider Active NPI

Lida Baucage-Perez, MD.

  • General Practice Physician
  • Savannah, GA
National Provider Identifier
1114957446
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13777 Issued in PR
Practice address
1170 Shawnee St
Savannah, GA 31419-1618
Phone
(912) 920-0214
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13777 PR Primary

Addresses

Primary practice location

1170 Shawnee St
Savannah, GA 31419-1618

Mailing address

1170 Shawnee St
Savannah, GA 31419-1618
Phone (912) 920-0214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171108000701 MI Order and Referring Only - General PracticePractitioner - General Practice 6406957257

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Serv Emerg del Noroeste Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1114957446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-920-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-920-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCAGE-PEREZ",
        "first_name": "LIDA",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.