Individual provider Active NPI

Serafim Perdikis, MD

  • Cardiovascular Disease Physician
  • Fort Sam Houston, TX
National Provider Identifier
1780786822
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
T7688 Issued in TX
Practice address
Brooke Army Medical Center
3851 Roger Brooke Dr
Fort Sam Houston, TX 78234-6200
Phone
(210) 292-7400
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241581 NY
Cardiovascular Disease Physician 207RC0000X 241581 NY
Cardiovascular Disease Physician 207RC0000X T7688 TX Primary

Addresses

Primary practice location

Brooke Army Medical Center
3851 Roger Brooke Dr
Fort Sam Houston, TX 78234-6200

Mailing address

3851 Roger Brooke Dr
Department of Medicine
Fort Sam Houston, TX 78234-6200

Other practice location 1

Wilford Hall Ambulatory Surgical Center
1100 Wilford Hall Loop
Lackland AFB, TX 78236
Phone (210) 292-7400

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
I20230131000195 TX Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5496047011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Clinic of San Antonio, PLLCGroup PAC ID 1153517420, 125 clinicians

Practice addresses (Care Compare)

4411 Medical Dr
Suite 300
San Antonio, TX 78229-3824
Phone (210) 614-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241581NYMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: serafim.perdikis@hca7.eclinicaldirectplus.com

Organizations & group practices 1

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 3

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780786822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3851 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200",
            "telephone_number": "210-292-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Wilford Hall Ambulatory Surgical Center",
            "address_2": "1100 Wilford Hall Loop",
            "address_purpose": "LOCATION",
            "city": "Lackland AFB",
            "state": "TX",
            "postal_code": "78236",
            "country_code": "US",
            "telephone_number": "210-292-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERDIKIS",
        "first_name": "SERAFIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "241581",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "241581",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "T7688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.