Arvin Penacerrada

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

License

170495 Issued in MD

Practice address

111 Vision Park Blvd Ste 250
Shenandoah, TX 77384-3004

Phone

(469) 909-2511

NPI assigned

May 6, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1477174993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 LOUETTA RD APT 4303",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773884879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD STE 250",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843004",
            "telephone_number": "469-909-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENACERRADA",
        "first_name": "ARVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MD",
            "license": "170495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARDMS",
            "identifier": "170495",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apenacerrada@metroveincenters.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "history",
            "address_1": "111 Vision Park Blvd Ste 250",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kara Kathleen Peace, PT, DPT
• Krista Pearce, LPC
• Ralph Purcell Pearce, M.D.
• Linda Tiffany Pearson, M.D.
• Dirk Peckhaus, DPT
• Jessica Pendergast, PA-C
• Richard Perches, M.D.
• Carlos Perez-Cosio, M.D.
• Carmen M Perez-Masuelli, M.D.,
• Petar Turcinovic MD PA

• Diagnostic Ultrasound Physician in Shenandoah, TX
• Providers in Shenandoah, TX by specialty
• Diagnostic Ultrasound Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.