Individual provider Active NPI

Nicholas Pereira, MD PA

  • Hospitalist Physician
  • Edinburg, TX
National Provider Identifier
1316941925
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
K3389 Issued in TX
Practice address
1102 W Trenton Rd
Edinburg, TX 78539-9105
Phone
(956) 388-6000
Fax
(956) 289-2956
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K3389 TX
Hospitalist Physician 208M00000X K3389 TX Primary

Addresses

Primary practice location

1102 W Trenton Rd
Edinburg, TX 78539-9105

Mailing address

5111 N 10TH St
# 112
McAllen, TX 78504-2835
Phone (956) 631-9739

Other practice location 1

5111 N 10th St
# 112
McAllen, TX 78504-2835
Phone (956) 631-9739

Other identifiers 2

IdentifierTypeStateIssuer
0029XROtherTXBC/BS
190654701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200114000343 TX Practitioner - Pediatric MedicinePractitioner - Hospitalist 1951736396

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3389TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McAllen Hospitalist Group, PLLC Hospitalist CurrentSince Jan 6, 2020 Accepting new patients
McAllen Hospitals L P Past Accepting new patients

Locations

1102 W Trenton Rd
Edinburg, TX 78539
Phone (956) 388-6500

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.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1316941925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N 10TH ST",
            "address_2": "# 112",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042835",
            "telephone_number": "956-631-9739",
            "fax_number": "956-631-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785399105",
            "telephone_number": "956-388-6000",
            "fax_number": "956-289-2956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5111 N 10th St",
            "address_2": "# 112",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785042835",
            "country_code": "US",
            "telephone_number": "956-631-9739",
            "fax_number": "956-631-6717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "NICHOLAS",
        "credential": "MD  PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K3389",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "K3389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0029XR",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190654701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.