Individual provider Active NPI

Stephen W Perez, MD

  • Emergency Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1225033897
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35069800 Issued in OH
Practice address
3131 Queen City Ave
Cincinnati, OH 45238-2316
Phone
(513) 557-3333
Fax
(513) 557-3332
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35069800 OH Primary

Addresses

Primary practice location

3131 Queen City Ave
Cincinnati, OH 45238-2316

Mailing address

1472 Solutions Ctr
Chicago, IL 60677-1004
Phone (513) 557-3333

Other identifiers 3

IdentifierTypeStateIssuer
0301257MedicaidOH
200116090MedicaidIN
64077878MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040604000153 OH Practitioner - Emergency Medicine 7416939251 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069800OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Columbus Radiology Corp Past Accepting new patients

Locations

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Organizations & group practices 2

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1225033897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771004",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 QUEEN CITY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382316",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35069800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0301257",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116090",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64077878",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.