NPIMap

Organization Active NPI

Emergency Pediatric Services, PA

  • Pediatric Critical Care Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1194854034
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
EMERGENCY PEDIATRIC SERVICES, PA
Practice address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone
(305) 662-8668
Fax
(305) 662-3723
NPI assigned
Mar 5, 2007
Last updated
Mar 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
Jorge E. Perez, MDNPI 1215037114
Title
Owner
Phone
(305) 661-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X NU Primary

Addresses

Primary practice location

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 662-8668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160519001921 FL Part B Supplier - Clinic/Group Practice 5991094609 Receives reassigned benefits from 24 practitioners
Practice locations: Boca Raton, FL; Boynton Beach, FL; Mangonia Park, FL

National Provider Directory

National Provider Directory
Tax ID family
Emergency Pediatric Services PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1194854034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-662-8668",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-662-8668",
            "fax_number": "305-662-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PEDIATRIC SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-661-1515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.