Individual provider Active NPI

Jaime Ricardo Perez

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1750160362
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61620342 Issued in WA
Practice address
1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone
(509) 452-4520
Fax
(509) 452-5224
NPI assigned
Sep 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61620342 WA
Family Nurse Practitioner 363LF0000X 7964753-4405 UT
Primary Care Nurse Practitioner 363LP2300X 7964753-8900 UT
Family Nurse Practitioner 363LF0000X AP61620342 WA Primary

Addresses

Primary practice location

1806 W Lincoln Ave
Yakima, WA 98902-2473

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 853-1082

Other practice location 1

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2292

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jperez233150@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240306000349 UT Practitioner - Nurse Practitioner 3870939481 Reassigns benefits to 2 organizations
I20250102002167 WA Practitioner - Nurse Practitioner 3870939481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health of Central WashingtonGroup PAC ID 4183536931, 77 clinicians

Practice addresses (Care Compare)

1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone (509) 452-4520

501 S 5TH Ave
Yakima, WA 98902-3550

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61620342WAMDNurse Practitioner
7964753-4405UTMDFamily Nurse Practitioner
7964753-8900UTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC CurrentSince May 1, 2024 Accepting new patients
Community Health of Central Washington CurrentSince Jan 6, 2025 Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2024 Accepting new patients
University of Utah Community Physicians Group Current Accepting new patients
Community Health of Central Washington CurrentSince Jan 6, 2025 Accepting new patients
Community Health of Central Washington Past Accepting new patients
Community Health of Central Washington Past Accepting new patients

Locations

165 N University Ave
Farmington, UT 84025
Phone (801) 213-3200

7495 S State St
Midvale, UT 84047
Phone (801) 213-9400

1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

127 S 500 E
Ste 400
Salt Lake City, UT 84102

1280 E Stringham Ave
Slc, UT 84106
Phone (801) 213-9077

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

5126 W Daybreak Pkwy
Ste 600
South Jordan, UT 84009

2675 W Taylorsville Blvd
Taylorsville, UT 84129
Phone (801) 982-0050

220 Millpond
Ste 100
Tooele, UT 84074
Phone (435) 843-3000

3730 W 4700 S
West Valley City, UT 84129
Phone (801) 213-9200

521 E Mountain View Ave
Ellensburg, WA 98926
Phone (509) 962-1414

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

402 S 12th Ave
Bsmt
Yakima, WA 98902

402 S 12th Ave
Yakima, WA 98902
Phone (509) 248-3263

Interoperability endpoints

  • Direct secure messaging: jperez233150@direct.med.utah.edu
  • Direct secure messaging: jperez761420@direct.ochin.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1750160362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-853-1082",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022473",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-581-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JAIME",
        "middle_name": "RICARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-22",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61620342",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7964753-4405",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "7964753-8900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61620342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jperez233150@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.