Individual provider Active NPI

Lance William Perez, PA-C

  • Surgical Physician Assistant
  • East Setauket, NY
National Provider Identifier
1427484971
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
017225 Issued in NY
Practice address
6 Technology Dr Ste 100
East Setauket, NY 11733-4079
Phone
(631) 689-6698
Fax
(631) 751-5548
NPI assigned
Sep 16, 2013
Last updated
May 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017225 NY
Surgical Physician Assistant 363AS0400X 017225 NY Primary

Addresses

Primary practice location

6 Technology Dr Ste 100
East Setauket, NY 11733-4079

Mailing address

6 Technology Dr Ste 100
East Setauket, NY 11733-4079
Phone (631) 689-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Long Island LLP CurrentSince Nov 4, 2013 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC Past Accepting new patients

Locations

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

55 Medford Ave
Unit E
Patchogue, NY 11772
Phone (631) 687-4190

74 Commerce Ave
Ste 4
Riverhead, NY 11901
Phone (631) 638-1670

60 Fleets Point Dr
Ste 1
West Babylon, NY 11704
Phone (631) 321-0033

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: lanceperez@oali.ssdirect.aprima.com

Organizations & group practices 2

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": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1427484971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR STE 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334079",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR STE 100",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334079",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LANCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017225",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.