Individual provider Active NPI

Lauren Michelle Perry, DO

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1659876449
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
307458 Issued in NY
Practice address
2381 Frederick Douglass Blvd
New York, NY 10027-1822
Phone
(888) 364-3065
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 307458 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2381 Frederick Douglass Blvd
New York, NY 10027-1822

Mailing address

9830 67TH Ave Apt 3K
Rego Park, NY 11374-4944
Phone (401) 338-8997

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (401) 338-8997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210819003056 NY Practitioner - Family Practice 6002211612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307458NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc Current Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Aug 2, 2021 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Aug 2, 2021 Accepting new patients
Ryan-Chelsea Clinton Community Health Center Past Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

110 W 97th St
#0
New York, NY 10025

2381 Frederick Douglass Blvd
New York, NY 10027
Phone (212) 749-6626

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: lauren.perry@wfrchc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1659876449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 67TH AVE APT 3K",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744944",
            "telephone_number": "401-338-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100271822",
            "telephone_number": "888-364-3065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "401-338-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "307458",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.