Individual provider Active NPI

Eros Perez, PSY D

  • Clinical Neuropsychologist
  • Edinburg, TX
National Provider Identifier
1144818170
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
38632 Issued in TX
Practice address
2808 Fountain Plaza Blvd
Edinburg, TX 78539-8031
Phone
(956) 665-8209
NPI assigned
Jan 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 38632 TX Primary

Addresses

Primary practice location

2808 Fountain Plaza Blvd
Edinburg, TX 78539-8031

Mailing address

501 E Camellia Ave Apt D132
McAllen, TX 78501-5679
Phone (305) 300-2534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002510 ME Practitioner - Clinical Psychologist 4587054085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Bangor, ME 04401-6630

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38632TXMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Oct 31, 2021 Accepting new patients
Eastern Maine Medical Center CurrentSince Oct 31, 2021 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1144818170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E CAMELLIA AVE APT D132",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785015679",
            "telephone_number": "305-300-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 FOUNTAIN PLAZA BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398031",
            "telephone_number": "956-665-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EROS",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "38632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.