Individual provider Active NPI

Joaquin Alberto Peralta, MD

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1336721885
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U9633 Issued in TX
Practice address
4835 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75244-6001
Phone
(281) 948-8275
NPI assigned
Apr 24, 2021
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PERA-DQXK4L NC
Emergency Medicine Physician 207P00000X U9633 TX Primary

Addresses

Primary practice location

4835 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75244-6001

Mailing address

4835 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75244-6001
Phone (281) 948-8275

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
I20240926002681 TX Practitioner - Emergency Medicine 8729497292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Western Michigan Un Homer Stryker School of Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17200 St Lukes Way
CHI St Lukes Health the Woodlands
The Woodlands, TX 77384-8007
Phone (936) 266-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PERA-DQXK4LNCMDEmergency Medicine Physician
U9633TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Aug 13, 2024 Accepting new patients

Locations

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

17400 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-4055

Interoperability endpoints

  • Direct secure messaging: jperalta356291@directhisp.wakemed.org

Organizations & group practices 1

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 2

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": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1336721885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 LYNDON B JOHNSON FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752446001",
            "telephone_number": "281-948-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 LYNDON B JOHNSON FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752446001",
            "telephone_number": "281-948-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "JOAQUIN",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-24",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "PERA-DQXK4L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U9633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.