Organization Active NPI

Perez Y Santos Renal Medical

  • Specialist
  • Ponce, PR
National Provider Identifier
1710100623
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PEREZ Y SANTOS RENAL MEDICAL
Practice address
3011 Ave Fagot
Ponce, PR 00716-3637
Phone
(787) 841-8201
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Dr. Daniel Perez, M.D.
Title
Doctor
Phone
(787) 841-8201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3011 Ave Fagot
Ponce, PR 00716-3637

Mailing address

PO Box 331990
Ponce, PR 00733-1990
Phone (787) 841-8201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910000768 PR Part B Supplier - Clinic/Group Practice 7113994187 Receives reassigned benefits from 2 practitioners
Practice locations: Ponce, PR

National Provider Directory

National Provider Directory

Locations

3011 Ave Emilio Fagot
Ponce, PR 00716
Phone (787) 841-8201

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1710100623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331990",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007331990",
            "telephone_number": "787-841-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 AVE FAGOT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163637",
            "telephone_number": "787-841-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREZ Y SANTOS RENAL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "787-841-8201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.