Individual provider Active NPI

Maricela Perez, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, IL
National Provider Identifier
1669697934
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277000234 Issued in IL
Practice address
314 E Downer PL
Aurora, IL 60505-3404
Phone
(630) 346-3995
Fax
(630) 884-3800
NPI assigned
Apr 13, 2007
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209005547 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277000234 IL Primary

Addresses

Primary practice location

314 E Downer PL
Aurora, IL 60505-3404

Mailing address

317 Le Grande Blvd
Aurora, IL 60506-4847
Phone (630) 346-3995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020000657 IL Practitioner - Nurse Practitioner 0749401602 Reassigns benefits to 2 organizations
Practice locations: Aurora, IL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Maria HealthGroup PAC ID 1557714839, 3 clinicians

Practice addresses (Care Compare)

314 E Downer PL
Aurora, IL 60505-3404
Phone (630) 346-3995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277000234ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Maria Health CurrentSince Nov 16, 2023 Accepting new patients

Locations

314 E Downer Pl
Aurora, IL 60505
Phone (630) 277-9608

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1669697934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 LE GRANDE BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064847",
            "telephone_number": "630-346-3995",
            "fax_number": "630-884-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E DOWNER PL",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053404",
            "telephone_number": "630-346-3995",
            "fax_number": "630-884-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARICELA",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005547",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277000234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.