NPIMap

Individual provider Active NPI

Jillian Perras

  • Specialist
  • Ronkonkoma, NY
National Provider Identifier
1447703087
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1143362 Issued in NY
Practice address
90 Air Park Dr
Ronkonkoma, NY 11779-7360
Phone
(631) 580-4001
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1143362 NY Primary
Specialist 174400000X NY

Addresses

Primary practice location

90 Air Park Dr
Ronkonkoma, NY 11779-7360

Mailing address

90 Air Park Dr
Ronkonkoma, NY 11779-7360
Phone (631) 580-4001

Other names 1

  • Jillian Daino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1143362NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ddi Past Accepting new patients
Developmental Disabilities Institute Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1447703087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 AIR PARK DR",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797360",
            "telephone_number": "631-580-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 AIR PARK DR",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797360",
            "telephone_number": "631-580-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRAS",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1143362",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "DAINO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.