Active NPI
George C Perdikis, MD
- Legal Medicine
- Lancaster, CA
National Provider Identifier
1336178128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- G59579
- Practice address
- 1669 W. Ave-J
Suite #308
Lancaster, CA 93534 - Phone
- (661) 940-5155
- Fax
- (661) 940-5157
- NPI assigned
- Jul 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | G59579 | CA | Primary |
Addresses
Primary practice location
1669 W. Ave-J
Suite #308
Lancaster, CA 93534
Mailing address
1669 W. Ave-J
Suite #308
Lancaster, CA 93534
Phone (661) 940-5155
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120105000514 | CA | Practitioner - Pain Management | 7113193533 | Practice locations: Lancaster, CA; Ridgecrest, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- University of California, Irvine, California College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1669 W Ave J
Suite 308
Lancaster, CA 93534-2870
Phone (661) 940-5155
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G59579 | CA | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336178128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1669 W. AVE-J",
"address_2": "SUITE #308",
"city": "LANCASTER",
"state": "CA",
"postal_code": "93534",
"telephone_number": "661-940-5155",
"fax_number": "661-940-5157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1669 W. AVE-J",
"address_2": "SUITE #308",
"city": "LANCASTER",
"state": "CA",
"postal_code": "93534",
"telephone_number": "661-940-5155",
"fax_number": "661-940-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERDIKIS",
"first_name": "GEORGE",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "CA",
"license": "G59579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.