Active NPI
Perla Perez
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1639786528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501019686
- Practice address
- 4120 E Beltline Ave NE
Grand Rapids, MI 49525-9660 - Phone
- (616) 365-2709
- NPI assigned
- Sep 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501019686 | MI | Primary |
Addresses
Primary practice location
4120 E Beltline Ave NE
Grand Rapids, MI 49525-9660
Mailing address
4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501019686 | Other | MI | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2014 E Madison St
Suite 100
Seattle, WA 98122-2965
Phone (206) 726-9551
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Functional Health Consulting, LLC | Current | Accepting new patients | |
| Functional Health Consulting, LLC | Current | Accepting new patients | |
| Functional Health Consulting, LLC | Physical Therapist | Current | Accepting new patients |
Locations
15 SW Everett Mall Way
Ste G
Everett, WA 98204
Phone (425) 355-5222
2014 E Madison St
Ste 100
Seattle, WA 98122
Phone (206) 726-9551
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.
-
dba Vida Integrated Health
- Sports Physician Chiropractor
- Seattle, WA
- NPI 1871801522
-
- Rehabilitation Chiropractor
- Bellevue, WA
- NPI 1366991572
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1639786528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4761 LAKE MICHIGAN DR NW STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495346300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 E BELTLINE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259660",
"telephone_number": "616-365-2709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "PERLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501019686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5501019686",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.