Individual provider Active NPI

Daniel Perez Brisebois, M.D

  • Specialist
  • Ponce, PR
National Provider Identifier
1780746305
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12062 Issued in PR
Practice address
3011 Ave Emilio Fagot
Ponce, PR 00716-3637
Phone
(787) 841-8201
Fax
(787) 841-8201
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12062 PR Primary

Addresses

Primary practice location

3011 Ave Emilio 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
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
I20110215000823 PR Practitioner - Nephrology 7113980608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Renal del Sur Corp Specialist CurrentSince Sep 23, 1996 Accepting new patients
Perez Y Santos Renal Medical Specialist CurrentSince Feb 1, 2001 Accepting new patients

Locations

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

Organizations & group practices 2

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 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1780746305",
    "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",
            "fax_number": "787-841-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 AVE EMILIO FAGOT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163637",
            "telephone_number": "787-841-8201",
            "fax_number": "787-841-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ BRISEBOIS",
        "first_name": "DANIEL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "12062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.