Marcella Denise Perez, M.D.
Individual provider Active NPI Pediatrics Physician · Louisville, KY
NPI 1174822720 · NPPES record last updated Sep 12, 2016
Key facts
- NPI
- 1174822720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 46859 (KY)
- Practice address
- 5109 New Cut Rd
Louisville, KY 40214-2745 - Phone
- (502) 361-1197
- Fax
- (502) 361-0090
- NPI assigned
- Mar 22, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140804002145 | KY | Practitioner - Pediatric Medicine | 4385861038 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Current |
Accepting new patients | |
| Community Medical Associates, Inc. | Current |
Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current |
Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current |
Accepting new patients | |
| Norton Childrens Medical Group, LLC | Pediatrics | Past | Accepting new patients |
Locations
5109 New Cut Rd
Louisville, KY 40214
Phone (502) 361-1197
100 Mallard Creek Rd
Ste 395
Louisville, KY 40207
Phone (502) 895-9421
601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670
3026 Poplar Level Rd
Louisville, KY 40217
Phone (502) 636-4929
825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165
2933 Breckenridge Ln
Ste 102
Louisville, KY 40220
Phone (502) 588-9588
Interoperability endpoints
- mperez43543@direct.nortonhealthcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 46859 | KY | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5109 New Cut Rd
Louisville, KY 40214-2745
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165148 | Other | KY | SIHO |
| 50075460 | Other | KY | PASSPORT - NCMA OKOLONA |
| 50083958 | Other | KY | PASSPORT - NCMA IROQUOIS |
| 000000885932 | Other | KY | ANTHEM-NCMA |
| 7100318020 | Medicaid | KY |
Other providers in Louisville, KY
- Nelly Mercedes Perez-Ricardo
- Alex Perez
- Carlos A Perez
- Jessica Raquel Perez
- Madison Perez
- Shannon R Perez
- Perfect Unity Behavioral Health LLC
- Perfect X Services LLC
- Danielle Renee Periago
- Perinatal Princess Group Therapy
All providers in Louisville, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.