Jeremy Christopher Peres

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS019048 Issued in PA

Practice address

1200 W Tabor Rd Ste 100
Philadelphia, PA 19141-3019

Phone

(267) 714-3682

NPI assigned

Aug 20, 2020

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Einstein Practice Plan Inc

  dba Einstein Psychiatry Assoc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment Care Compare group NPD
• Jeremy Peres, PHD, PSYD, LLC

  • Clinical Psychologist
  • Drexel Hill, PA
  • NPI 1477399384
  NPD Authorized official
• AIDS Care Group

  • Clinic/Center
  • Chester, PA
  • NPI 1477592400
  Medicare reassignment
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan Inc

  dba Einstein Radiology Associates

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1396703955
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1659983708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 GARRETT RD # 1064",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263040",
            "telephone_number": "267-714-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W TABOR RD STE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413019",
            "telephone_number": "267-714-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERES",
        "first_name": "JEREMY",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raul Alcides Pereira, D.M.D
• Grace Pereles, CRNP
• Vladimir Simon Perelshteyn, M.D.
• Perennial Counseling
• Perennial Integrative Therapy PLLC
• Adan Pereyra, MA
• Marien Del Carmen Perez Gomez
• Rogelio Eduardo Perez Iglesias
• Ana Mercedes Perez Osorio, DMD
• Perez Therapy, LLC

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.