Individual provider Active NPI

Tania E Perez, ARNP

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1174197966
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1114165 Issued in TX
Practice address
5580 19TH CT SW Ste 2
Naples, FL 34116-5577
Phone
(239) 304-2471
Fax
(239) 304-2741
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1114165 TX Primary

Addresses

Primary practice location

5580 19TH CT SW Ste 2
Naples, FL 34116-5577

Mailing address

4517 Kingwood Dr
Kingwood, TX 77345-2621
Phone (832) 831-9094

Other identifiers 1

IdentifierTypeStateIssuer
013900300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220103001684 FL Practitioner - Nurse Practitioner 9133510084 Reassigns benefits to 1 organization
I20240825000087 TX Practitioner - Nurse Practitioner 9133510084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Physician AssociatesGroup PAC ID 8022354638, 11 clinicians

Practice addresses (Care Compare)

6306 Fairbanks N Houston Rd
Suite 500
Houston, TX 77040-5193
Phone (832) 831-9094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1114165TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Physician Associates CurrentSince Jun 13, 2024 Accepting new patients
VKJ Associates Corp CurrentSince Mar 5, 2023 Accepting new patients
SW Florida Regional Medical Center Inc CurrentSince Nov 18, 2021 Accepting new patients
Brazos Medical Center Past Accepting new patients

Locations

5580 19th Ct SW
Ste 2
Naples, FL 34116
Phone (239) 304-2471

6306 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (713) 732-4677

6302 Fairbanks N Houston Rd
Ste 500
Houston, TX 77040
Phone (832) 831-9094

4517 Kingwood Dr
Kingwood, TX 77345
Phone (281) 358-0013

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9289/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJHBD/Endpoint/EHJHBD

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1174197966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 KINGWOOD DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452621",
            "telephone_number": "832-831-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5580 19TH CT SW STE 2",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165577",
            "telephone_number": "239-304-2471",
            "fax_number": "239-304-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TANIA",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1114165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013900300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.