Individual provider Active NPI

Edgardo Perez, MD

  • General Practice Physician
  • Lares, PR
National Provider Identifier
1235161944
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13663 Issued in PR
Practice address
Carr 111 KM 22.9 Bo. Lares
Lares, PR 00669
Phone
(787) 473-3541
Fax
(787) 563-7971
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13663 PR Primary

Addresses

Primary practice location

Carr 111 KM 22.9 Bo. Lares
Lares, PR 00669

Mailing address

PO Box 334
Lares, PR 00669
Phone (787) 563-7971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20090114000009 PR Practitioner - General Practice 4284797416 Practice locations: Lares, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Diagnostico Y Tratamiento Dr Caparros Inc Past Accepting new patients
Centro Diagnostico Y Tratamiento Dr Caparros Inc. General Practice Past Accepting new patients

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1235161944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-563-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 111 KM 22.9 BO. LARES",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-473-3541",
            "fax_number": "787-563-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EDGARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.