Christopher Timothy Pereida, MSN, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95012512 Issued in CA

Practice address

1600 W Avenue J
Lancaster, CA 93534-2814

Phone

(661) 726-6225

Fax

(661) 949-5191

NPI assigned

Dec 3, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.53 of 100Reported as group

Quality

85.33

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Antelope Valley Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Lancaster, CA
  • NPI 1225054257

  Multi-Specialty

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1316584907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W AVENUE L",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347211",
            "telephone_number": "661-723-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-726-6225",
            "fax_number": "661-949-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 W Avenue L",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935347211",
            "country_code": "US",
            "telephone_number": "661-723-6884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREIDA",
        "first_name": "CHRISTOPHER",
        "middle_name": "TIMOTHY",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-03",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95012512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.t.pereida@kp.org",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "SOCAL PERMANENTE MEDICAL GROUP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Work Email",
            "address_1": "615 W Avenue L",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935347211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 N 15th St",
            "city": "LANCASTER",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Maria Coleman Perdue
• Lesly Perez Alvizurez
• Yaritza Perez Cortez
• Ximena Perez Garcia
• Jessy Perez-Nava
• Araceli Perez

• Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.