Individual provider Active NPI

Renee Lynn Perkis, M.D.

  • Family Medicine Physician
  • Bear, DE
National Provider Identifier
1710943956
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0058324 Issued in MD
Practice address
404 Foxhunt Dr
Bear, DE 19701-2538
Phone
(302) 652-2455
Fax
(302) 322-6252
NPI assigned
Apr 25, 2006
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0058324 MD Primary

Addresses

Primary practice location

404 Foxhunt Dr
Bear, DE 19701-2538

Mailing address

PO Box 151
New Castle, DE 19720-0151
Phone (302) 652-2455

Other practice location 1

349 E Pulaski Hwy
Elkton, MD 21921-6415
Phone (410) 398-4510

Other identifiers 2

IdentifierTypeStateIssuer
DE6737OtherMDMEDICARE RAILROAD GROUP
P00308151OtherMDMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208000166 DE Practitioner - Family Practice 9133113681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Healthcare, Inc.Group PAC ID 6800706599, 58 clinicians

Practice addresses (Care Compare)

1802 W 4TH St
Wilmington, DE 19805-3420
Phone (302) 655-5576

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0058324MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Family Healthcare, Inc. CurrentSince Nov 29, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Westside Family Healthcare, Inc. Past Accepting new patients
Westside Family Healthcare, Inc Past Accepting new patients

Locations

1802 W 4th St
Wilmington, DE 19805
Phone (302) 655-5576

908 E 16th St
Ste B
Wilmington, DE 19802
Phone (302) 225-1800

Interoperability endpoints

  • Direct secure messaging: renee.perkis.1@20122.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1710943956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197200151",
            "telephone_number": "302-652-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 FOXHUNT DR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012538",
            "telephone_number": "302-652-2455",
            "fax_number": "302-322-6252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "349 E Pulaski Hwy",
            "address_purpose": "LOCATION",
            "city": "Elkton",
            "state": "MD",
            "postal_code": "219216415",
            "country_code": "US",
            "telephone_number": "410-398-4510",
            "fax_number": "410-398-5160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKIS",
        "first_name": "RENEE",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0058324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "DE6737",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00308151",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.