Individual provider Active NPI

Luke Prakash Peris, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1770613994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J5864 Issued in TX
Practice address
14800 Quorum Dr
465
Dallas, TX 75254-7073
Phone
(972) 661-2066
Fax
(972) 661-0313
NPI assigned
Mar 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J5864 TX Primary

Addresses

Primary practice location

14800 Quorum Dr
465
Dallas, TX 75254-7073

Mailing address

14800 Quorum Dr
465
Dallas, TX 75254-7073
Phone (972) 661-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080401000212 TX Practitioner - Psychiatry 4486730454 Reassigns benefits to 1 organization
Practice locations: Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14800 Quorum Dr
Suite 465
Dallas, TX 75254-1420
Phone (972) 661-2066

14800 Quorum Dr
Suite 465
Dallas, TX 75254-7073

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luke Peris MD PastSince Jan 1, 1990 Accepting new patients
Bent Tree Psychiatric Assoc Psychiatry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: luke.peris.1@27034.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770613994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 QUORUM DR",
            "address_2": "465",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547073",
            "telephone_number": "972-661-2066",
            "fax_number": "972-661-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 QUORUM DR",
            "address_2": "465",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547073",
            "telephone_number": "972-661-2066",
            "fax_number": "972-661-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIS",
        "first_name": "LUKE",
        "middle_name": "PRAKASH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J5864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.