Individual provider Active NPI

Luis Daniel Perez, P.A.

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1629011085
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03892 Issued in TX
Practice address
1200 Brooklyn Ave
320
San Antonio, TX 78212-4803
Phone
(210) 396-5310
Fax
(210) 396-5316
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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 PA03892 TX Primary

Addresses

Primary practice location

1200 Brooklyn Ave
320
San Antonio, TX 78212-4803

Mailing address

1200 Brooklyn Ave
320
San Antonio, TX 78212-4803
Phone (210) 396-5310

Other identifiers 4

IdentifierTypeStateIssuer
PA03892MedicaidTX
8N4701OtherTXBCBS
7863511OtherTXAETNA
P00217741OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040417000247 TX Practitioner - Physician Assistant 5991790123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19138 US Hwy 281 N
San Antonio, TX 78258-4988
Phone (210) 804-5400

400 Concord Plaza Dr
Suite 300
San Antonio, TX 78216-6991
Phone (210) 804-5400

Merit-based Incentive Payment System (MIPS)

Final score
79.86 of 100Reported as group
Quality
65.93
Promoting interoperability
94
Improvement activities
40
Cost
71.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The San Antonio Orthopaedic Group, LLP CurrentSince Sep 1, 2003 Accepting new patients
The San Antonio Orthopaedic Group, LLP CurrentSince Sep 1, 2003 Accepting new patients
Trinity Regional Medical Center Past Accepting new patients

Locations

1200 Brooklyn Ave
Ste 320
San Antonio, TX 78212
Phone (210) 225-5741

11212 State Highway 151
Ste 150
San Antonio, TX 78251
Phone (210) 233-1215

400 Concord Plaza Dr
Ste 300
San Antonio, TX 78216
Phone (210) 804-5416

Interoperability endpoints

  • Direct secure messaging: luis.perez.pa.1@94.direct.athenahealth.com

Organizations & group practices 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1629011085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE",
            "address_2": "320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124803",
            "telephone_number": "210-396-5310",
            "fax_number": "210-396-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE",
            "address_2": "320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124803",
            "telephone_number": "210-396-5310",
            "fax_number": "210-396-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LUIS",
        "middle_name": "DANIEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA03892",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N4701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7863511",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00217741",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.