Individual provider Active NPI

Maria D Perez, MD

  • Internal Medicine Physician
  • Wilmington, DE
National Provider Identifier
1386649424
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C10001604 Issued in DE
Practice address
1701 Augustine Cut Off
Building 1, Suite 12
Wilmington, DE 19803-4415
Phone
(302) 571-0730
Fax
(302) 571-0357
NPI assigned
Jun 16, 2005
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10001604 DE Primary

Addresses

Primary practice location

1701 Augustine Cut Off
Building 1, Suite 12
Wilmington, DE 19803-4415

Mailing address

1701 Augustine Cut Off
Building 1, Suite 12
Wilmington, DE 19803-4415
Phone (302) 571-0730

Other identifiers 3

IdentifierTypeStateIssuer
0000032601MedicaidDE
6032OtherDECOVENTRY HEALTHCARE
4313374OtherDEAETNA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10001604DEMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1386649424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 AUGUSTINE CUT OFF",
            "address_2": "BUILDING 1, SUITE 12",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198034415",
            "telephone_number": "302-571-0730",
            "fax_number": "302-571-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 AUGUSTINE CUT OFF",
            "address_2": "BUILDING 1, SUITE 12",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198034415",
            "telephone_number": "302-571-0730",
            "fax_number": "302-571-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10001604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000032601",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE",
            "identifier": "6032",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4313374",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.