Individual provider Active NPI

Mileidys Perez Gutierrez, PA

  • Medical Physician Assistant
  • Caguas, PR
National Provider Identifier
1225656226
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000555-P.A. Issued in PR
Practice address
201 Ave Gautier Benitez, Consolidated Medical Plaza
Suite 101
Caguas, PR 00725
Phone
(787) 744-5278
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000555-P.A. PR Primary

Addresses

Primary practice location

201 Ave Gautier Benitez, Consolidated Medical Plaza
Suite 101
Caguas, PR 00725

Mailing address

201 Ave Gautier Benitez, Consolidated Medical Plaza
Suite 101
Caguas, PR 00725
Phone (787) 744-5278

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000555-P.A.PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nuscan CSP PastSince Jul 12, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1225656226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 AVE GAUTIER BENITEZ, CONSOLIDATED MEDICAL PLAZA",
            "address_2": "SUITE 101",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-744-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 AVE GAUTIER BENITEZ, CONSOLIDATED MEDICAL PLAZA",
            "address_2": "SUITE 101",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-744-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ GUTIERREZ",
        "first_name": "MILEIDYS",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "000555-P.A.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.