Active NPI
Timothy Allen Perez, RN, MN, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Tigard, OR
National Provider Identifier
1760651442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 200950089NP
- Practice address
- 7105 SW Varns St
Suite 270
Tigard, OR 97223-8173 - Phone
- (503) 389-1500
- Fax
- (800) 974-5025
- NPI assigned
- Feb 26, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 200950089NP | OR | Primary |
Addresses
Primary practice location
7105 SW Varns St
Suite 270
Tigard, OR 97223-8173
Mailing address
7105 SW Varns St
Suite 270
Tigard, OR 97223-8173
Phone (503) 389-1500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valuecore Mental Health | Psychiatric/Mental Health | Past | Accepting new patients |
| Marion County | Past | Accepting new patients | |
| County of Polk | Past | Accepting new patients | |
| Marion County | Past | Accepting new patients |
Interoperability endpoints
- valuerispsychiatricservices.timothyperez@134015.advancedmd-direct.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 and National Provider Directory roles.
-
- State or Local Public Health Clinic/Center
- Dallas, OR
- NPI 1710910781
-
dba Marion County Health Department
- Adult Mental Health Clinic/Center
- Salem, OR
- NPI 1528147782
-
- Psychiatric/Mental Health Nurse Practitioner
- Canby, OR
- NPI 1093444622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441929600000",
"number": "1760651442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7105 SW VARNS ST",
"address_2": "SUITE 270",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238173",
"telephone_number": "503-389-1500",
"fax_number": "800-974-5025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7105 SW VARNS ST",
"address_2": "SUITE 270",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238173",
"telephone_number": "503-389-1500",
"fax_number": "800-974-5025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "TIMOTHY",
"middle_name": "ALLEN",
"credential": "RN, MN, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-26",
"last_updated": "2015-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "200950089NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.