Individual provider Active NPI

Diwata M Perez, BS PHAR

  • Pharmacist
  • Surprise, AZ
National Provider Identifier
1174749402
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15915 Issued in NV
Practice address
15170 W Bell Rd Ste 100
Surprise, AZ 85374
Phone
(702) 339-2183
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15915 NV Primary

Addresses

Primary practice location

15170 W Bell Rd Ste 100
Surprise, AZ 85374

Mailing address

10603 W El Cortez PL
Peoria, AZ 85383-9677
Phone (702) 339-2183

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
15915NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Belles Pharmacy LLC CurrentSince Jan 5, 2020 Accepting new patients
Belles Pharmacy LLC Current Accepting new patients

Locations

15170 W Bell Rd
Ste 100
Surprise, AZ 85374
Phone (623) 398-3650

Organizations & group practices 2

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1174749402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10603 W EL CORTEZ PL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853839677",
            "telephone_number": "702-339-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15170 W BELL RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "702-339-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DIWATA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "BS PHAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "15915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.