Active NPI
Jacqueline Cecile Perez
- Internal Medicine Physician
- Brooklyn, NY
National Provider Identifier
1184727232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 196206
- Practice address
- 300 Skillman Ave
Lutheran Family HLTH Ctr. - Community Medicine Program
Brooklyn, NY 11211-1607 - Phone
- (718) 302-7333
- Fax
- (718) 963-4016
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 196206 | NY | Primary |
Addresses
Primary practice location
300 Skillman Ave
Lutheran Family HLTH Ctr. - Community Medicine Program
Brooklyn, NY 11211-1607
Mailing address
300 Skillman Ave
Lutheran Family HLTH Ctr. - Community Medicine Program
Brooklyn, NY 11211-1607
Phone (718) 302-7333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02202826 | Medicaid | NY |
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 Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenwich Village Medical Group, PC | Internal Medicine | 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.
-
- Internal Medicine Physician
- New York, NY
- NPI 1225249204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1184727232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SKILLMAN AVE",
"address_2": "LUTHERAN FAMILY HLTH CTR. - COMMUNITY MEDICINE PROGRAM",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112111607",
"telephone_number": "718-302-7333",
"fax_number": "718-963-4016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SKILLMAN AVE",
"address_2": "LUTHERAN FAMILY HLTH CTR. - COMMUNITY MEDICINE PROGRAM",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112111607",
"telephone_number": "718-302-7333",
"fax_number": "718-963-4016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JACQUELINE",
"middle_name": "CECILE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "196206",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02202826",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.