Active NPI
Nicholas Pereira, MD PA
- Hospitalist Physician
- Edinburg, TX
National Provider Identifier
1316941925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- K3389
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0029XR | Other | TX | BC/BS |
| 190654701 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200114000343 | TX | Practitioner - Pediatric Medicine | 1951736396 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K3389 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McAllen Hospitalist Group, PLLC | Hospitalist | Current | 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.
-
- General Acute Care Hospital
- Edinburg, TX
- NPI 1770573586
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.