Individual provider Active NPI

Cesar Augusto Peralta

  • Internal Medicine Physician
  • Lubbock, TX
National Provider Identifier
1164059283
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V0836 Issued in TX
Practice address
3601 4TH St
Lubbock, TX 79430-8736
Phone
(806) 743-1088
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X V0836 TX Primary

Addresses

Primary practice location

3601 4TH St
Lubbock, TX 79430-8736

Mailing address

2102 Treasure Hills Blvd
Harlingen, TX 78550-8736

Other practice location 1

2102 Treasure Hills Blvd
Harlingen, TX 78550-8736
Phone (956) 296-1491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240726002518 TX Practitioner - Internal Medicine 0244776185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 6709028954, 49 clinicians

Practice addresses (Care Compare)

11011 Slide Rd
Lubbock, TX 79424-2274
Phone (806) 775-8200

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686
  • Carlsbad Medical Center Hospital, Carlsbad, NM, CCN 320063
  • Memorial Hospital Hospital, Seminole, TX, CCN 451358

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District CurrentSince Aug 1, 2024 Accepting new patients

Locations

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

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.

Hospital & facility affiliations 8

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1164059283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 TREASURE HILLS BLVD",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794308736",
            "telephone_number": "806-743-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2102 Treasure Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785508736",
            "country_code": "US",
            "telephone_number": "956-296-1491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "CESAR",
        "middle_name": "AUGUSTO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V0836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.