Individual provider Active NPI

Jorge Amed Fernandez Perez, MD

  • General Practice Physician
  • Tamarac, FL
National Provider Identifier
1407559966
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME176613 Issued in FL
Practice address
7166 N Nob Hill Rd
Tamarac, FL 33321-1839
Phone
(786) 583-5100
NPI assigned
Mar 23, 2023
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME176613 FL Primary

Addresses

Primary practice location

7166 N Nob Hill Rd
Tamarac, FL 33321-1839

Mailing address

7166 N Nob Hill Rd
Tamarac, FL 33321-1839
Phone (786) 583-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251222003650 FL Practitioner - General Practice 3476048984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCC Medical Holdings LLCGroup PAC ID 0446679468, 27 clinicians

Practice addresses (Care Compare)

7166 N Nob Hill Rd
PCC of Tamarac
Tamarac, FL 33321-1839
Phone (954) 718-8700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME176613FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Medical Holdings LLC CurrentSince Dec 15, 2025 Accepting new patients

Locations

7166 N Nob Hill Rd
Tamarac, FL 33321
Phone (786) 583-5100

2911 N Military Trl
Ste D
West Palm Beach, FL 33409
Phone (561) 478-8825

Interoperability endpoints

  • Direct secure messaging: jorge.fernandez.1@32578.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1407559966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7166 N NOB HILL RD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211839",
            "telephone_number": "786-583-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7166 N NOB HILL RD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211839",
            "telephone_number": "786-583-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ PEREZ",
        "first_name": "JORGE",
        "middle_name": "AMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME176613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.