Individual provider Active NPI

Tina Lea Perez

  • General Practice Registered Nurse
  • Bellevue, NE
National Provider Identifier
1285447284
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
85057 Issued in NE
Practice address
11812 Golden Blvd Apt 904
Bellevue, NE 68123-3114
Phone
(712) 899-3042
NPI assigned
Jan 31, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 85057 NE Primary

Addresses

Primary practice location

11812 Golden Blvd Apt 904
Bellevue, NE 68123-3114

Mailing address

11812 Golden Blvd Apt 904
Bellevue, NE 68123-3114
Phone (712) 899-3042

Other names 1

  • Tina Lea Perez-Hernandez Professional name

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

State licenses

LicenseStateTypeSpecialty
85057NEMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1285447284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11812 GOLDEN BLVD APT 904",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681233114",
            "telephone_number": "712-899-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11812 GOLDEN BLVD APT 904",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681233114",
            "telephone_number": "712-899-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TINA",
        "middle_name": "LEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NE",
            "license": "85057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "PEREZ-HERNANDEZ",
            "middle_name": "LEA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.