Individual provider Active NPI

David Perry, Jr., PA-C

  • Physician Assistant
  • Wayne, NJ
National Provider Identifier
1487736294
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00162900 Issued in NJ
Practice address
1500 Alps Rd
Wayne, NJ 07470-3635
Phone
(973) 628-8500
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00162900 NJ Primary

Addresses

Primary practice location

1500 Alps Rd
Wayne, NJ 07470-3635

Mailing address

900 Route 109
Cape May, NJ 08204-5259
Phone (609) 884-4357

Other identifiers 1

IdentifierTypeStateIssuer
25MP00162900OtherNJLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070419000067 NJ Practitioner - Physician Assistant 8325040272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

100 E Main St
Tuckerton, NJ 08087-2618
Phone (609) 296-4014

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone (609) 340-7815

900 Route 109
Cape May, NJ 08204-5259
Phone (609) 407-2273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group Past Accepting new patients

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1487736294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 109",
            "city": "CAPE MAY",
            "state": "NJ",
            "postal_code": "082045259",
            "telephone_number": "609-884-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ALPS RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703635",
            "telephone_number": "973-628-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY, JR.",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00162900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "25MP00162900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.