Individual provider Active NPI

Rolando Perez Jr., MD

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1174844633
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P1012 Issued in TX
Practice address
2882 Holly Rd
Corpus Christi, TX 78415-4106
Phone
(361) 814-2001
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P1012 TX Primary

Addresses

Primary practice location

2882 Holly Rd
Corpus Christi, TX 78415-4106

Mailing address

2882 Holly Rd
Corpus Christi, TX 78415-4106

Other identifiers 2

IdentifierTypeStateIssuer
3229437-01MedicaidTX
3229437-02OtherTXMEDICAID CSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000566 TX Practitioner - Family Practice 0143467282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Bend Wellness Foundation IncGroup PAC ID 9931422649, 13 clinicians

Practice addresses (Care Compare)

2882 Holly Rd
Corpus Christi, TX 78415-4106
Phone (361) 814-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P1012TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Bend Wellness Foundation Inc CurrentSince Jun 15, 2021 Accepting new patients
Coastal Bend Wellness Foundation Inc. CurrentSince Jun 15, 2021 Accepting new patients
Tri County Family Medical Care Group LLC Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chest Diagnostic Therapeutic SVCS & Transit Nursing of TX, Inc Past Accepting new patients

Locations

2882 Holly Rd
Corpus Christi, TX 78415
Phone (361) 814-2001

Organizations & group practices 5

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1174844633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 HOLLY RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784154106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2882 HOLLY RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784154106",
            "telephone_number": "361-814-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ROLANDO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3229437-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "3229437-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.