Jacob Manuel Perreira, AGPCNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

28251946A Issued in IN

Practice address

1481 W 10TH St
Indianapolis, IN 46202-2803

Phone

(317) 988-1772

NPI assigned

Mar 1, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1346996295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5843 MINDEN DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462219379",
            "telephone_number": "815-474-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREIRA",
        "first_name": "JACOB",
        "middle_name": "MANUEL",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "IN",
            "license": "28251946A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "28251946A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyton Michelle Perkins
• Stephen W Perkins, MD
• Tiffany Victoria Perkins, LPN
• Hannah Perkinson
• Mark Jacob Perlow, M.D.
• Megan Perria, M. ED LSLS CERT AVED
• Thomas Perrin, MD
• Jeffrey Perron
• Suzanne Elizabeth Perron
• Jennifer Lynn Perrone, LCSW

• Primary Care Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.

Verify at the official NPI Registry.