Individual provider Active NPI

Ronald Nino Miranda Perez, MD

  • Family Medicine Physician
  • Carlsbad, CA
National Provider Identifier
1295967594
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A132584 Issued in CA
Practice address
1207 Carlsbad Village Dr Ste a
Carlsbad, CA 92008
Phone
(760) 896-3030
Fax
(760) 896-3033
NPI assigned
Aug 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A132584 CA Primary

Addresses

Primary practice location

1207 Carlsbad Village Dr Ste a
Carlsbad, CA 92008

Mailing address

2604-B El Camino Real
#261
Carlsbad, CA 92008
Phone (760) 896-3030

Other practice location 1

2604 El Camino Real # 261B
Carlsbad, CA 92008-1205
Phone (304) 907-0687

Other practice location 2

1207 Carlsbad Village Dr Ste A
Carlsbad, CA 92008
Phone (760) 896-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170622000194 CA Practitioner - Family Practice 7911154588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1207 Carlsbad Village Dr
Suite a
Carlsbad, CA 92008-1958
Phone (760) 896-3030

2604 B El Camino Real
Suite 261
Carlsbad, CA 92008-1214

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald Nino M Perez M D PC Family Medicine CurrentSince Jun 30, 2017 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients

Locations

2604 El Camino Real
Ste B
Carlsbad, CA 92008
Phone (702) 524-0367

1207 Carlsbad Village Dr
Ste A
Carlsbad, CA 92008
Phone (760) 434-7374

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ronald.nino.perez.2@19742.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1295967594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604-B EL CAMINO REAL",
            "address_2": "#261",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "760-896-3030",
            "fax_number": "760-896-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR STE A",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "760-896-3030",
            "fax_number": "760-896-3033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2604 El Camino Real # 261B",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920081205",
            "country_code": "US",
            "telephone_number": "304-907-0687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 Carlsbad Village Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "92008",
            "country_code": "US",
            "telephone_number": "760-896-3030",
            "fax_number": "760-896-3033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RONALD NINO",
        "middle_name": "MIRANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A132584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.