Jennifer Monic Perdomo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A188828 Issued in CA

Practice address

450 E Spring St Ste 1
Long Beach, CA 90806-1625

Phone

(562) 933-0050

Fax

(562) 933-0079

NPI assigned

Mar 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Family Practice

Education

University of Southern California Keck School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jennifer.perdomomd.p1@direct.plannedparenthoodla.nextgenshare.com

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Planned Parenthood of Greater New York Inc

  • Ambulatory Family Planning Facility
  • Brooklyn, NY
  • NPI 1417959701
  NPD (past)

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

• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1639707243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E SPRING ST STE 1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061625",
            "telephone_number": "562-933-0050",
            "fax_number": "562-933-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E SPRING ST STE 1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061625",
            "telephone_number": "562-933-0050",
            "fax_number": "562-933-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "JENNIFER",
        "middle_name": "MONIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A188828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kusi Hilda Peralta, LCSW
• Katie Peraudeau
• Amanda C Peraza, LCSW 114253
• Jessica Peraza, L.C.S.W.
• Yuliya Perch, MD
• Jayla Manansala Peredo
• Laura Pereira
• Osmin Adiel Pereira
• Jonathan Perez Perey
• Linda Perez Enriquez

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.