Individual provider Active NPI

Andrea Pereira, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Charleston, SC
National Provider Identifier
1609937192
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD37514 Issued in SC
Practice address
1137 Sam Rittenberg Blvd
Charleston, SC 29407-3360
Phone
(843) 608-9293
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD37514 SC Primary

Addresses

Primary practice location

1137 Sam Rittenberg Blvd
Charleston, SC 29407-3360

Mailing address

401 N Michigan Ave
Suite 1200
Chicago, IL 60611-4264
Phone (312) 635-0973

Other identifiers 2

IdentifierTypeStateIssuer
375141MedicaidSC
P01451574OtherSCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201029001690 DC Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 3476788993 Reassigns benefits to 1 organization
I20201110001592 VA Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 3476788993 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD37514SCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of FL, LLC CurrentSince Oct 19, 2020 Accepting new patients
Vohra Wound Physicians of FL, LLC CurrentSince Oct 19, 2020 Accepting new patients
National Health Rehabilitation LLC Physical Medicine & Rehabilitation CurrentSince Sep 6, 2022 Accepting new patients
Pioneer Spine and Sports Physicians, PC PastSince Jun 23, 2003 Accepting new patients
Connecticut Spine and Sports Physicians, Inc. Physical Medicine & Rehabilitation Past Accepting new patients

Locations

100 M St SE
Ste 600
Washington, DC 20003
Phone (202) 574-5700

1785 S Hayes St
Arlington, VA 22202
Phone (703) 920-0980

1017 George Washington Hwy N
Chesapeake, VA 23323
Phone (757) 485-5000

10701 Main St
Fairfax, VA 22030
Phone (703) 273-7705

7300 Forest Ave
Richmond, VA 23226
Phone (804) 280-3152

3900 Westerre Pkwy
Richmond, VA 23233
Phone (703) 491-6167

831 E Ellerslie Ave
South Chesterfield, VA 23834
Phone (718) 298-7345

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1609937192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MICHIGAN AVE",
            "address_2": "SUITE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114264",
            "telephone_number": "312-635-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073360",
            "telephone_number": "843-608-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "MD37514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375141",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01451574",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.