Individual provider Active NPI

Malachi Perez

  • Physician Assistant
  • New York, NY
National Provider Identifier
1619784246
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033180 Issued in NY
Practice address
2257 Adam Clayton Powell Jr Blvd
New York, NY 10027-7979
Phone
(212) 281-5252
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033180 NY Primary

Addresses

Primary practice location

2257 Adam Clayton Powell Jr Blvd
New York, NY 10027-7979

Mailing address

37-12 108TH St
Corona, NY 11368

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
I20250624004040 NY Practitioner - Physician Assistant 0648782755 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033180NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hemant Patel MD PC Past 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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1619784246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37-12 108TH ST",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 ADAM CLAYTON POWELL JR BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277979",
            "telephone_number": "212-281-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MALACHI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.