Individual provider Active NPI

Maurice Clive Perry, M.D.

  • Diagnostic Radiology Physician
  • Lancaster, PA
National Provider Identifier
1265433833
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD064604L Issued in PA
Practice address
555 N Duke St
Lancaster, PA 17602-2250
Phone
(717) 394-6028
Fax
(717) 394-9223
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD064604L PA Primary

Addresses

Primary practice location

555 N Duke St
Lancaster, PA 17602-2250

Mailing address

PO Box 4216
Lancaster, PA 17604-4216
Phone (717) 394-6028

Other identifiers 5

IdentifierTypeStateIssuer
001365081MedicaidPA
231855378OtherPATAX ID - LANC RADIOLOGY
047809YYYOtherPAMEDICARE PTAN
300121888OtherPARAILROAD MEDICARE
33-1011386OtherPATAX ID - MRI GROUP, LLP

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD064604LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Pet Partnership, LLP Past Accepting new patients
MRI Group, LLP Diagnostic Radiology 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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1265433833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4216",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176044216",
            "telephone_number": "717-394-6028",
            "fax_number": "717-394-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N DUKE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022250",
            "telephone_number": "717-394-6028",
            "fax_number": "717-394-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MAURICE",
        "middle_name": "CLIVE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD064604L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001365081",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID - LANC RADIOLOGY",
            "identifier": "231855378",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "047809YYY",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300121888",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID - MRI GROUP, LLP",
            "identifier": "33-1011386",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.