NPIMap

Individual provider Active NPI

Gaston O. Perez, M.D. F.A.A.F.P.

  • Family Medicine Physician
  • Bluffton, SC
National Provider Identifier
1629188586
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17810 Issued in SC
Practice address
14 Oak Forest Rd
Suite D
Bluffton, SC 29910-4988
Phone
(843) 815-6468
Fax
(843) 815-6492
NPI assigned
Aug 30, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17810 SC Primary

Addresses

Primary practice location

14 Oak Forest Rd
Suite D
Bluffton, SC 29910-4988

Mailing address

14 Oak Forest Rd
Suite D
Bluffton, SC 29910-4988
Phone (843) 815-6468

Other identifiers 1

IdentifierTypeStateIssuer
17814MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728000334 SC Practitioner - Family Practice 9133255706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14 Oak Forest Rd D
Bluffton, SC 29910-4988
Phone (843) 815-6468

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17810SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Global Family Medicine, LLC Family Medicine CurrentSince Aug 1, 2001 Accepting new patients
South Carolina Health Service Family Medicine Past Accepting new patients

Locations

14 Oak Forest Rd
Ste D
Bluffton, SC 29910
Phone (843) 815-6468

Interoperability endpoints

  • Direct secure messaging: gaston.perez.1@23431.direct.athenahealth.com
  • Direct secure messaging: gaston.perez.1@29822.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1629188586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 OAK FOREST RD",
            "address_2": "SUITE D",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104988",
            "telephone_number": "843-815-6468",
            "fax_number": "843-815-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 OAK FOREST RD",
            "address_2": "SUITE D",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104988",
            "telephone_number": "843-815-6468",
            "fax_number": "843-815-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "GASTON",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.  F.A.A.F.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "17810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17814",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.