Individual provider Active NPI

Richard Allen Perez, M.D.

  • Pediatrics Physician
  • Sarasota, FL
National Provider Identifier
1477559516
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME56640 Issued in FL
Practice address
5664 Bee Ridge Rd
Ste. 202
Sarasota, FL 34233-1504
Phone
(941) 377-6406
Fax
(941) 377-6407
NPI assigned
Jun 23, 2005
Reactivated
Apr 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME56640 FL Primary

Addresses

Primary practice location

5664 Bee Ridge Rd
Ste. 202
Sarasota, FL 34233-1504

Mailing address

5664 Bee Ridge Rd
Ste. 202
Sarasota, FL 34233-1504
Phone (941) 377-6406

Other identifiers 2

IdentifierTypeStateIssuer
062103000MedicaidFL
45150OtherFLBC BS PROVIDER #

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME56640FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Pediatrics of Sarasota, PA-C Specialist Past Accepting new patients
Gulf Coast Pediatrics of Sarasota, P.a. Specialist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: richard.perez.1@6904.direct.athenahealth.com

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1477559516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5664 BEE RIDGE RD",
            "address_2": "STE. 202",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331504",
            "telephone_number": "941-377-6406",
            "fax_number": "941-377-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5664 BEE RIDGE RD",
            "address_2": "STE. 202",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331504",
            "telephone_number": "941-377-6406",
            "fax_number": "941-377-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME56640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062103000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER #",
            "identifier": "45150",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.