Individual provider Active NPI

Esmil Perez Chavez, M.D.

  • Pediatrics Physician
  • Davie, FL
National Provider Identifier
1801174453
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME112118 Issued in FL
Practice address
6200 Falconsgate Ave
Davie, FL 33331-2926
Phone
(240) 676-5724
Fax
(786) 360-2509
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME112118 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6200 Falconsgate Ave
Davie, FL 33331-2926

Mailing address

6200 Falconsgate Ave
Davie, FL 33331-2926
Phone (240) 676-5724

Other practice location 1

4777 N Congress Ave
Boynton Beach, FL 33426-7941
Phone (561) 328-8712

Other identifiers 1

IdentifierTypeStateIssuer
006336900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130529000644 FL Practitioner - Pediatric Medicine 4880832054 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 26, 2021 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 26, 2021 Accepting new patients
Soma Medical Center PA 2 Pediatrics PastSince Sep 23, 2021 Accepting new patients
Marshland Emergency Physicians, LLC Past Accepting new patients
Soma Medical Center PA 7 Pediatrics PastSince Jul 4, 2021 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1801174453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 FALCONSGATE AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312926",
            "telephone_number": "240-676-5724",
            "fax_number": "786-360-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 FALCONSGATE AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312926",
            "telephone_number": "240-676-5724",
            "fax_number": "786-360-2509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4777 N Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334267941",
            "country_code": "US",
            "telephone_number": "561-328-8712",
            "fax_number": "561-209-5013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ CHAVEZ",
        "first_name": "ESMIL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME112118",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006336900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.