NPIMap

Individual provider Active NPI

Michael Perez, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1215906078
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
170543 Issued in NY
Practice address
4915 Broadway
Suite #1G
New York, NY 10034-3119
Phone
(212) 544-9513
Fax
(212) 544-0402
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 170543 NY Primary

Addresses

Primary practice location

4915 Broadway
Suite #1G
New York, NY 10034-3119

Mailing address

4915 Broadway
Suite #1G
New York, NY 10034-3119
Phone (914) 525-7637

Other identifiers 1

IdentifierTypeStateIssuer
01196487MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050729000591 NY Practitioner - Internal MedicinePractitioner - Nephrology 0446288690 Reassigns benefits to 1 organization
Practice locations: New York, NY; Yonkers, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

127 S Broadway
Yonkers, NY 10701-4006
Phone (212) 544-9513

4915 Broadway
1G
New York, NY 10034-3119
Phone (212) 544-9513

967 N Broadway
Yonkers, NY 10701-1301
Phone (212) 544-9513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
13.65 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
45.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John'S Riverside Hospital-HS CurrentSince Feb 19, 2024 Accepting new patients
Excella Medicine PC Nephrology PastSince Jan 1, 1990 Accepting new patients
Dignicare Medical PLLC Past Accepting new patients
RLD Medical Services, PC PastSince Jul 1, 2001 Accepting new patients
Park Gardens Rehabilitation and Nursing Center LLC Past Accepting new patients
Forest Hills Dermatology Group PLLC PastSince Sep 1, 2012 Accepting new patients

Locations

2 Park Ave
Yonkers, NY 10703
Phone (914) 964-7300

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: michael.perez.1@27811.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1215906078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "address_2": "SUITE #1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343119",
            "telephone_number": "914-525-7637",
            "fax_number": "212-544-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "address_2": "SUITE #1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343119",
            "telephone_number": "212-544-9513",
            "fax_number": "212-544-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "170543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01196487",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.