Individual provider Active NPI

Elizabeth Herrera Perez, MD

  • Family Medicine Physician
  • Boardman, OH
National Provider Identifier
1497459481
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57254887 Issued in OH
Practice address
8423 Market St Ste 101
Boardman, OH 44512-6778
Phone
(330) 729-8700
Fax
(330) 729-8701
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 57254887 OH Primary

Addresses

Primary practice location

8423 Market St Ste 101
Boardman, OH 44512-6778

Mailing address

8423 Market St Ste 101
Boardman, OH 44512-6778
Phone (330) 729-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711003100 OH Order and Referring Only - Family PracticePractitioner - Family Practice 5991164741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57254887OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC PastSince Apr 6, 2023 Accepting new patients
Mercy Health Physicians Youngstown, LLC Family Medicine PastSince Apr 6, 2023 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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1497459481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA PEREZ",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57254887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.