Active NPI
Michael John Perez II
- Physician Assistant
- Spokane Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60794753
- Practice address
- 1502 N Vercler Rd
Spokane Valley, WA 99216-1078 - Phone
- (509) 444-8204
- Fax
- (509) 434-0321
- NPI assigned
- Aug 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60794753 | WA | Primary |
Addresses
Primary practice location
1502 N Vercler Rd
Spokane Valley, WA 99216-1078
Mailing address
611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888
Other practice location 1
16528 E Desmet Ct
Spokane Valley, WA 99216-3522
Phone (509) 944-8910
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mperez219100@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60794753 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients |
Locations
611 N Iron Bridge Way
Spokane, WA 99202
5901 N Lidgerwood St
Ste 126
Spokane, WA 99208
Phone (509) 434-1990
1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205
203 N Washington St
Ste 300
Spokane, WA 99201
1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204
15812 E Indiana Ave
Ste 101
Spokane Valley, WA 99216
Interoperability endpoints
- mperez219100@wm.providencedirect.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.
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1326005851
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1295946101
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1679363592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1497209571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N IRON BRIDGE WAY",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992024932",
"telephone_number": "509-444-8888",
"fax_number": "509-444-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 N VERCLER RD",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161078",
"telephone_number": "509-444-8204",
"fax_number": "509-434-0321"
}
],
"practiceLocations": [
{
"address_1": "16528 E Desmet Ct",
"address_purpose": "LOCATION",
"city": "Spokane Valley",
"state": "WA",
"postal_code": "992163522",
"country_code": "US",
"telephone_number": "509-944-8910",
"fax_number": "509-474-6606",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-07",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60794753",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mperez219100@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "16528 E Desmet Ct",
"city": "Spokane Valley",
"state": "WA",
"country_code": "US",
"postal_code": "992163522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.