Individual provider Active NPI

Jennifer Ann Perez

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1548834492
Registry record updated May 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F347616-01 Issued in NY
Practice address
330 W 28TH St Apt 17D
New York, NY 10001-4756
Phone
(646) 522-3349
NPI assigned
May 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F347616-01 NY Primary

Addresses

Primary practice location

330 W 28TH St Apt 17D
New York, NY 10001-4756

Mailing address

330 W 28TH St Apt 17D
New York, NY 10001-4756
Phone (646) 522-3349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220629000965 NY Practitioner - Nurse Practitioner 5597145110 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F347616-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Medical Services of New York, PLLC CurrentSince Apr 1, 2022 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Apr 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Apr 1, 2022 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Apr 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Apr 1, 2022 Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Interoperability endpoints

  • Direct secure messaging: jennifer.perez.1@24989.direct.athenahealth.com

Organizations & group practices 5

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": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621123200000",
    "number": "1548834492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 28TH ST APT 17D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014756",
            "telephone_number": "646-522-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 28TH ST APT 17D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014756",
            "telephone_number": "646-522-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-16",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F347616-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.