Active NPI
Sergio Perez
- Physician Assistant
- Peterson Afb, CO
National Provider Identifier
1164490272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 559 Vincent St
Peterson Afb, CO 80914-1540 - Phone
- (719) 556-1060
- Fax
- (719) 556-9677
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
559 Vincent St
Peterson Afb, CO 80914-1540
Mailing address
559 Vincent St
Peterson Afb, CO 80914-1540
Phone (719) 556-1060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053651 | Other | NCC PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1164490272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 VINCENT ST",
"city": "PETERSON AFB",
"state": "CO",
"postal_code": "809141540",
"telephone_number": "719-556-1060",
"fax_number": "719-556-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 VINCENT ST",
"city": "PETERSON AFB",
"state": "CO",
"postal_code": "809141540",
"telephone_number": "719-556-1060",
"fax_number": "719-556-9677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "SERGIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCC PA",
"identifier": "1053651",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Peterson Afb, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.