Organization Active NPI

Fernandezperez MD LLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Bayamon, PR
National Provider Identifier
1508692575
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
Legal business name
FERNANDEZPEREZ MD LLC
Practice address
B1 Calle Santa Cruz
Carimed Plaza 403
Bayamon, PR 00961-6928
Phone
(787) 798-7070
NPI assigned
Sep 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Samuel Fernandez Perez, MDNPI 1144635319
Title
Ceo
Phone
(787) 798-7070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X Primary

Addresses

Primary practice location

B1 Calle Santa Cruz
Carimed Plaza 403
Bayamon, PR 00961-6928

Mailing address

B1 Calle Santa Cruz
Carimed Plaza 403
Bayamon, PR 00961-6928
Phone (787) 798-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250910001644 PR Part B Supplier - Clinic/Group Practice 4284137910 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

B1 Calle Santa Cruz
Ste 403
Bayamon, PR 00961
Phone (787) 798-0670

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1508692575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B1 CALLE SANTA CRUZ",
            "address_2": "CARIMED PLAZA 403",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616928",
            "telephone_number": "787-798-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B1 CALLE SANTA CRUZ",
            "address_2": "CARIMED PLAZA 403",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616928",
            "telephone_number": "787-798-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDEZPEREZ MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ PEREZ",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-798-7070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.