NPIMap

Individual provider Active NPI

Sergio Giovanni Perossa, MD

  • Internal Medicine Physician
  • Cypress, TX
National Provider Identifier
1316086317
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M9576 Issued in TX
Practice address
10720 Barker Cypress Rd
Cypress, TX 77433-1372
Phone
(281) 345-4800
Fax
(281) 345-4803
NPI assigned
Feb 6, 2007
Last updated
Jun 25, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2004-0381 NM
Internal Medicine Physician 207R00000X M9576 TX Primary

Addresses

Primary practice location

10720 Barker Cypress Rd
Cypress, TX 77433-1372

Mailing address

10720 Barker Cypress Rd
Cypress, TX 77433-1372
Phone (281) 345-4800

Other identifiers 1

IdentifierTypeStateIssuer
8W2435OtherTXBLUE CROSS BLUE SHIELD OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080428000376 TX Practitioner - Internal MedicinePractitioner - Family Practice 9537247812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

10720 Barker Cypress Rd
Cypress, TX 77433-3129
Phone (713) 347-6828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-0381NMMDInternal Medicine Physician
M9576TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Practice, L.L.P Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Villagemd of Southeast Texas, PA Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Inpatient Medicine Physicians PA PastSince Apr 1, 2024 Accepting new patients
Lone Star Extensivists PLLC Internal Medicine PastSince Sep 1, 2024 Accepting new patients

Locations

10720 Barker Cypress Rd
Cypress, TX 77433
Phone (281) 345-4800

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

Interoperability endpoints

  • Direct secure messaging: sergio.perossa.1@13711.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1316086317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 BARKER CYPRESS RD",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774331372",
            "telephone_number": "281-345-4800",
            "fax_number": "281-345-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 BARKER CYPRESS RD",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774331372",
            "telephone_number": "281-345-4800",
            "fax_number": "281-345-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROSSA",
        "first_name": "SERGIO",
        "middle_name": "GIOVANNI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2004-0381",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "8W2435",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.