Antolin Julian Perez, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

28835 Issued in KY

Practice address

727 Hospital Dr
Shelbyville, KY 40065-1660

Phone

(502) 647-4085

Fax

(502) 647-4098

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kentucky Anesthesia Partners PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1750917357
  Medicare reassignment NPD
• Radius Anesthesia of Kentucky, PLLC

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
  • NPI 1679020689

  Anesthesiology

  Medicare reassignment NPD

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1417032202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 LONGVIEW PARK PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402456217",
            "telephone_number": "502-489-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4085",
            "fax_number": "502-647-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANTOLIN",
        "middle_name": "JULIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "28835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200902390A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100046920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric and Neonatal Practice
• Pediatric Dentistry of Shelbyville
• Pediatric Products, LLC
• Pediatric Products, LLC
• Penny Pendleton
• Anna Nicole Perlack, OT
• Amanda Lee Petersen, OTR
• Ashley Peterson
• Hannah Nicole Peterson
• Jessica Peterson, LSW

• Anesthesiology Physician in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Anesthesiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.