Individual provider Active NPI

Michelle Renee Perez, MD

  • Pediatrics Physician
  • Madera, CA
National Provider Identifier
1629531785
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
178155 Issued in CA
Practice address
441 E Yosemite Ave
Madera, CA 93638-3604
Phone
(559) 664-4000
Fax
(559) 675-5224
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 178155 CA Primary

Addresses

Primary practice location

441 E Yosemite Ave
Madera, CA 93638-3604

Mailing address

441 E Yosemite Ave
Madera, CA 93638-3604
Phone (559) 664-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220818002624 CA Practitioner - Pediatric Medicine 4688057946 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178155CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health Pediatrics Current Accepting new patients
Camarena Health CurrentSince Jun 7, 2022 Accepting new patients
Camarena Health CurrentSince Jun 7, 2022 Accepting new patients

Locations

730 N I St
Ste 202
Madera, CA 93637

441 E Yosemite Ave
Madera, CA 93638

730 E Almond Ave
Madera, CA 93637

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Interoperability endpoints

  • Direct secure messaging: mperez78466@valleychildrens-prd.direct-ci.com
  • Direct secure messaging: michelle.perez.1@25900.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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1629531785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 E YOSEMITE AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383604",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 E YOSEMITE AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383604",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "178155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.