Individual provider Active NPI

Lilia Peress, MD

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1275945446
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301500558 Issued in MI
Practice address
5570 State St
Saginaw, MI 48603-3583
Phone
(989) 583-0100
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301500558 MI Primary

Addresses

Primary practice location

5570 State St
Saginaw, MI 48603-3583

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200113001052 MI Practitioner - Family Practice 0648605030 Reassigns benefits to 1 organization
I20210514001959 CA Practitioner - Family Practice 0648605030 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301500558MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 22, 2021 Accepting new patients
Covenant Medical Center, Inc Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Feb 22, 2021 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Jan 1, 2020 Accepting new patients

Locations

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

16440 Gratiot Rd
Hemlock, MI 48626
Phone (989) 583-0660

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

5570 State St
Saginaw, MI 48603
Phone (989) 583-0100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1275945446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033583",
            "telephone_number": "989-583-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERESS",
        "first_name": "LILIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301500558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.