Active NPI
Samantha E Perez, DO
- Psychiatry Physician
- Ann Arbor, MI
National Provider Identifier
1174029383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 5101026021
- Practice address
- 2215 Fuller Rd # 116C
Ann Arbor, MI 48105-2303 - Phone
- (734) 769-7100
- NPI assigned
- Apr 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5101026021 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 5101026021 | MI | Primary |
Addresses
Primary practice location
2215 Fuller Rd # 116C
Ann Arbor, MI 48105-2303
Mailing address
2215 Fuller Rd # 116C
Ann Arbor, MI 48105-2303
Phone (734) 735-4610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101026021 | MI | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- sperez753403@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1174029383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 FULLER RD # 116C",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481052303",
"telephone_number": "734-735-4610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 FULLER RD # 116C",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481052303",
"telephone_number": "734-769-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "SAMANTHA",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5101026021",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5101026021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.