NPIMap

Individual provider Active NPI

Edward A Perez, M.D.

  • Orthopaedic Trauma Physician
  • Ft Lauderdale, FL
National Provider Identifier
1457348153
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
35461 Issued in TN
Practice address
1601 S Andrews Ave FL 2
Ft Lauderdale, FL 33316-2509
Phone
(954) 355-3490
Fax
(954) 355-3498
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 35461 TN Primary

Addresses

Primary practice location

1601 S Andrews Ave FL 2
Ft Lauderdale, FL 33316-2509

Mailing address

1700 NW 49TH St Ste 125
Ft Lauderdale, FL 33309-3750
Phone (954) 355-3490

Other identifiers 4

IdentifierTypeStateIssuer
143747001MedicaidAR
104102200MedicaidFL
00124729MedicaidMS
3864612MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080625000493 TN Practitioner - Orthopedic Surgery 8123199783 Reassigns benefits to 1 organization
I20190925001766 FL Practitioner - Orthopedic Surgery 8123199783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rush Medical College of Rush University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

1601 S Andrews Ave
Fort Lauderdale, FL 33316-2509

201 E Sample Rd
Deerfield Beach, FL 33064-3502

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35461TNMDOrthopaedic Trauma Physician

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
North Broward Hospital District Current Accepting new patients
North Broward Hospital District CurrentSince Oct 14, 2019 Accepting new patients
North Broward Hospital District CurrentSince Oct 14, 2019 Accepting new patients
CC Bpci PLC Past Accepting new patients
North Broward Hospital District Past Accepting new patients
North Broward Hospital District Orthopaedic Trauma Past Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

1601 S Andrews Ave
Ste 2
Ft Lauderdale, FL 33316

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

1601 S Andrews Ave
Fl 2
Ft Lauderdale, FL 33316
Phone (954) 355-3490

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eperez@cco1043.srs-direct.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/4ec99ef7-2f74-4efb-9ab9-a702c7c570f4/

Organizations & group practices 30

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.

View all 30

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1457348153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-355-3490",
            "fax_number": "954-355-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ANDREWS AVE FL 2",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162509",
            "telephone_number": "954-355-3490",
            "fax_number": "954-355-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TN",
            "license": "35461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143747001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104102200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124729",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3864612",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.