Individual provider Active NPI

Jerome J Perra, MD

  • Orthopaedic Surgery Physician
  • Hastings, MN
National Provider Identifier
1174591275
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
38049 Issued in MN
Practice address
1285 Nininger Rd
Suite 107
Hastings, MN 55033-1086
Phone
(651) 842-5412
Fax
(651) 437-2988
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 38049 MN Primary

Addresses

Primary practice location

1285 Nininger Rd
Suite 107
Hastings, MN 55033-1086

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30507IAMDStudent in an Organized Health Care Education/Training Program
30537IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics LTD Current Accepting new patients

Locations

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Interoperability endpoints

  • Direct secure messaging: jeromejperra@sol.allscriptsdirect.net

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.

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": "1435190400000",
    "number": "1174591275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 NININGER RD",
            "address_2": "SUITE 107",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331086",
            "telephone_number": "651-842-5412",
            "fax_number": "651-437-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRA",
        "first_name": "JEROME",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "38049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.