NPIMap

Individual provider Active NPI

Sandra Lynn Perez, NP

  • Nurse Practitioner
  • Half Moon Bay, CA
National Provider Identifier
1396728044
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
313381 Issued in CA
Practice address
344 Garcia Ave
Half Moon Bay, CA 94019-1851
Phone
(415) 750-2115
Fax
(415) 750-2181
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 313381 CA Primary

Addresses

Primary practice location

344 Garcia Ave
Half Moon Bay, CA 94019-1851

Mailing address

344 Garcia Ave
Half Moon Bay, CA 94019-1851
Phone (415) 750-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000548 CA Practitioner - Nurse Practitioner 0840465324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

  • San Mateo Medical Center Hospital, San Mateo, CA, CCN 050113
  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sperez19866@smch.direct-ci.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.

Hospital & facility affiliations 10

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1396728044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 GARCIA AVE",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191851",
            "telephone_number": "415-750-2115",
            "fax_number": "415-750-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 GARCIA AVE",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191851",
            "telephone_number": "415-750-2115",
            "fax_number": "415-750-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "313381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Half Moon Bay, CA

Sources for this page

Verify at the official NPI Registry.