Active NPI
Walter Alexis Perez, NP
- Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1700336245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95005174
- Practice address
- 763 E 52ND St
Los Angeles, CA 90011-4031 - Phone
- (323) 251-9327
- NPI assigned
- Oct 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95005174 | CA | Primary |
Addresses
Primary practice location
763 E 52ND St
Los Angeles, CA 90011-4031
Mailing address
5901 E 7TH St
Long Beach, CA 90822-5201
Phone (323) 251-9327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181211002705 | CA | Order and Referring Only - Nurse Practitioner | 8224386180 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85938 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546819200000",
"number": "1700336245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201",
"telephone_number": "323-251-9327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "763 E 52ND ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900114031",
"telephone_number": "323-251-9327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "WALTER",
"middle_name": "ALEXIS",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-07",
"last_updated": "2019-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95005174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.