NPIMap

Individual provider Active NPI

Rodolfo Perez Jr., FNP

  • Family Nurse Practitioner
  • Montclair, CA
National Provider Identifier
1134557648
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23311 Issued in CA
Practice address
9635 Monte Vista Ave Ste 205
Montclair, CA 91763-2235
Phone
(909) 906-3446
Fax
(909) 966-4450
NPI assigned
Oct 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23311 CA Primary

Addresses

Primary practice location

9635 Monte Vista Ave Ste 205
Montclair, CA 91763-2235

Mailing address

9635 Monte Vista Ave Ste 205
Montclair, CA 91763-2235
Phone (909) 906-3446

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140708001356 CA Practitioner - Nurse Practitioner 9931324951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J and D Healthcare IncGroup PAC ID 3072871243, 2 clinicians

Practice addresses (Care Compare)

9635 Monte Vista Ave
Suite 205
Montclair, CA 91763-2235
Phone (909) 906-3446

Hospital & facility affiliations

  • Elite Care Home Health Services, Inc Home health agency, Los Angeles, CA, CCN 559409
  • DSP Home Health Inc Home health agency, West Covina, CA, CCN 058053
  • Compliance Home Health Care Services, Inc. Home health agency, San Bernardino, CA, CCN 757771
  • Ark Home Health, Inc. Home health agency, Upland, CA, CCN 758122
  • Mother Theresa'S Home Health Services Home health agency, Burbank, CA, CCN 058224
  • Riverside Community Hospital Hospital, Riverside, CA, CCN 050022
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Garden View Post Acute Rehabilitation Nursing home, Baldwin Park, CA, CCN 055187
  • Madera Post Acute Center Nursing home, El Monte, CA, CCN 055141
  • Beacon Healthcare Center Nursing home, West Covina, CA, CCN 056331
  • Ontario Grove Healthcare & Wellness Centre, LP Nursing home, Ontario, CA, CCN 055693
  • Harvard Creek Post Acute Nursing home, Covina, CA, CCN 055544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1134557648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 MONTE VISTA AVE STE 205",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632235",
            "telephone_number": "909-906-3446",
            "fax_number": "909-966-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 MONTE VISTA AVE STE 205",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632235",
            "telephone_number": "909-906-3446",
            "fax_number": "909-966-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RODOLFO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-18",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.