Individual provider Active NPI

Leah P. Perez, M.D.

  • Psychiatry Physician
  • Greenwood, SC
National Provider Identifier
1144250473
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20-22193 Issued in SC
Practice address
600 Monument St
Suite 224
Greenwood, SC 29646-2638
Phone
(864) 227-3908
Fax
(864) 227-2668
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20-22193 SC Primary

Addresses

Primary practice location

600 Monument St
Suite 224
Greenwood, SC 29646-2638

Mailing address

600 Monument St
Suite 224
Greenwood, SC 29646-2638
Phone (864) 227-3908

Other identifiers 1

IdentifierTypeStateIssuer
221931MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080729000171 IL Practitioner - Psychiatry 1759455512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Group practices
BHC Streamwood Hospital IncGroup PAC ID 1759291461, 13 clinicians

Practice addresses (Care Compare)

1400 E Irving Park Rd
Streamwood, IL 60107-3201
Phone (630) 837-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20-22193SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Streamwood Hospital Inc. CurrentSince Aug 1, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2008 Accepting new patients
Methodist Medical Center of Illinois Psychiatry CurrentSince Jul 1, 2008 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

120 NE Glen Oak Ave
Ste 101
Peoria, IL 61603
Phone (309) 671-8230

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

900 Main St
Ste 500
Peoria, IL 61602
Phone (309) 637-3500

1400 E Irving Park Rd
Streamwood, IL 60107
Phone (630) 483-5578

Organizations & group practices 4

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

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": "1196640000000",
    "number": "1144250473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MONUMENT ST",
            "address_2": "SUITE 224",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462638",
            "telephone_number": "864-227-3908",
            "fax_number": "864-227-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MONUMENT ST",
            "address_2": "SUITE 224",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462638",
            "telephone_number": "864-227-3908",
            "fax_number": "864-227-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LEAH",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "20-22193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221931",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.