Individual provider Active NPI

Jose M. Perez, M.D.

  • Surgery Physician
  • La Canada, CA
National Provider Identifier
1396799185
Registry record updated Sep 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A88799 Issued in CA
Practice address
1111 Foothill Blvd Ste C
La Canada, CA 91011-3207
Phone
(818) 900-2063
Fax
(818) 296-1074
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A88799 CA Primary

Addresses

Primary practice location

1111 Foothill Blvd Ste C
La Canada, CA 91011-3207

Mailing address

2029 Verdugo Blvd # 120
Montrose, CA 91020-1626
Phone (818) 900-2063

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmperezmd@me.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060203000460 CA Practitioner - General Surgery 2365456829 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88799CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Mar 1, 2014 Accepting new patients
Usc Care Medical Group, Inc Surgery CurrentSince Mar 1, 2014 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients

Locations

16030 Ventura Blvd
Ste 150
Encino, CA 91436
Phone (818) 500-9999

222 W Eulalia St
Ste 200
Glendale, CA 91204
Phone (818) 291-4010

1510 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 500-9934

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1396799185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 VERDUGO BLVD # 120",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201626",
            "telephone_number": "818-900-2063",
            "fax_number": "818-296-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FOOTHILL BLVD STE C",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910113207",
            "telephone_number": "818-900-2063",
            "fax_number": "818-296-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOSE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A88799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmperezmd@me.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1111 Foothill Blvd Ste C",
            "city": "LA Canada",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910113207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.