Organization Active NPI

Perry Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Melbourne, FL
National Provider Identifier
1467930826
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME103032 Issued in FL
Legal business name
PERRY ORTHOPEDICS LLC
Practice address
1700 W Hibiscus Blvd
Melbourne, FL 32901-2615
Phone
(321) 500-5633
Fax
(321) 617-5633
NPI assigned
Jul 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Dr. John Jay Perry, MDNPI 1861548463
Title
Ceo
Phone
(321) 500-5633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X ME103032 FL Primary

Addresses

Primary practice location

1700 W Hibiscus Blvd
Melbourne, FL 32901-2615

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 500-5633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409000500 FL Part B Supplier - Clinic/Group Practice 9638410228 Receives reassigned benefits from 3 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

1700 W Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 473-8989

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1467930826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-500-5633",
            "fax_number": "321-617-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012615",
            "telephone_number": "321-500-5633",
            "fax_number": "321-617-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY ORTHOPEDICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-500-5633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME103032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.