Mario Fernando Pereyra – Occupational Therapist

Key facts

NPI: 1689010084
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: 2680 (NM)
Practice address: 498 Chalan Palosyo
Agana Heights, GU 96910-6427
Phone: (671) 475-5801
Fax: (671) 475-5855
NPI assigned: May 13, 2013
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2680	NM	MD	Occupational Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	2680	NM	Yes

Addresses

Primary practice location

498 Chalan Palosyo
Agana Heights, GU 96910-6427

Mailing address

241 Condo LN Apt 712
Tamuning, GU 96913-3145
Phone (671) 988-9651

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 13, 2013.

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1689010084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CONDO LN APT 712",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133145",
            "telephone_number": "671-988-9651",
            "fax_number": "671-475-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 CHALAN PALOSYO",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "969106427",
            "telephone_number": "671-475-5801",
            "fax_number": "671-475-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREYRA",
        "first_name": "MARIO",
        "middle_name": "FERNANDO",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "2680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agana Heights, GU

All providers in Agana Heights, GU · Occupational Therapist in Guam

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.