Active NPI
Edward Perez, O.T.R.
- Pediatric Occupational Therapist
- Staten Island, NY
National Provider Identifier
1174763270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 007956-1
- Practice address
- 25 Belmont PL
Staten Island, NY 10301-1709 - Phone
- (917) 494-8499
- Fax
- (718) 876-0531
- NPI assigned
- Mar 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 007956-1 | NY | Primary |
Addresses
Primary practice location
25 Belmont PL
Staten Island, NY 10301-1709
Mailing address
25 Belmont PL
Staten Island, NY 10301-1709
Phone (917) 494-8499
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007956-1 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Swing OT PC | Pediatrics | Past | Accepting new patients |
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": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339113600000",
"number": "1174763270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 BELMONT PL",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103011709",
"telephone_number": "917-494-8499",
"fax_number": "718-876-0531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 BELMONT PL",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103011709",
"telephone_number": "917-494-8499",
"fax_number": "718-876-0531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "O.T.R.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-02",
"last_updated": "2012-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "007956-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.