Individual provider Active NPI

Nicole M Perez, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1477029684
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5888 Issued in SC
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 778-7800
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 50.005759RX OH
Physician Assistant 363A00000X 5888 SC Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

3553 Boynton Rd
Cleveland, OH 44121-1516
Phone (305) 607-3588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250924000269 SC Practitioner - Physician Assistant 3678817525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4600 McAuley PL
Blue Ash, OH 45242-4765

4600 McAuley PL
Suite 600
Blue Ash, OH 45242-4778

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Aug 11, 2025 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Aug 11, 2025 Accepting new patients
The Metrohealth System Current Accepting new patients

Locations

4600 McAuley Pl
Ste 600
Blue Ash, OH 45242
Phone (513) 752-8000

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

317 Saint Francis Dr
Ste 340
Greenville, SC 29601
Phone (864) 255-1834

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

Interoperability endpoints

  • Direct secure messaging: nperez147856@direct.metrohealth.org

Organizations & group practices 3

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1477029684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 BOYNTON RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441211516",
            "telephone_number": "305-607-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005759RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.