Active NPI
Ilenia Perez, P.T.
- Physical Therapist
- Fresno, CA
National Provider Identifier
1376799676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34619
- Practice address
- 1630 E Herndon Ave
Fresno, CA 93720-3391 - Phone
- (559) 256-5200
- Fax
- (559) 256-5376
- NPI assigned
- Aug 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT34619 | CA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | PT34619 | CA | |
| Physical Therapist | 225100000X | PT34619 | CA | Primary |
Addresses
Primary practice location
1630 E Herndon Ave
Fresno, CA 93720-3391
Mailing address
8302 Espresso Dr Ste 100
Bakersfield, CA 93312-5688
Phone (661) 377-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT34619 | Other | CA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT34619 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feld Care Therapy Inc | Physical Therapist | Past | Accepting new patients |
Interoperability endpoints
- ilenia.perez.p1@direct.spocortho.nextgenshare.com
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 and National Provider Directory roles.
-
- Physical Therapist
- Tampa, FL
- NPI 1134075864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1376799676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8302 ESPRESSO DR STE 100",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933125688",
"telephone_number": "661-377-1700",
"fax_number": "661-616-9199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 E HERNDON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203391",
"telephone_number": "559-256-5200",
"fax_number": "559-256-5376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "ILENIA",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-18",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT34619",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "PT34619",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT34619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PT34619",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.