NPIMap

Individual provider Active NPI

Jean Carlos Tejada Perez, MD

  • Internal Medicine Physician
  • Oakland Park, FL
National Provider Identifier
1821449414
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME154926 Issued in FL
Practice address
3460 N Andrews Ave
Oakland Park, FL 33309-6060
Phone
(954) 947-3227
Fax
(954) 947-5198
NPI assigned
Jun 25, 2016
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME154926 FL Primary

Addresses

Primary practice location

3460 N Andrews Ave
Oakland Park, FL 33309-6060

Mailing address

3460 N Andrews Ave
Oakland Park, FL 33309-6060
Phone (954) 947-3227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191206000274 SD Practitioner - Internal MedicinePractitioner - Family Practice 8022441971 Reassigns benefits to 1 organization
I20220928002869 FL Practitioner - Internal Medicine 8022441971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (850) 469-2313

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154926FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Current Accepting new patients
Pensacola Hospitalist Physicians, LLC Current Accepting new patients
Sanford Health Network CurrentSince Sep 22, 2019 Accepting new patients
Pensacola Hospitalist Physicians, LLC CurrentSince Aug 1, 2023 Accepting new patients
Sanford Health Network CurrentSince Sep 22, 2019 Accepting new patients

Locations

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

2905 3rd Ave SE
Aberdeen, SD 57401
Phone (605) 226-5500

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1821449414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 N ANDREWS AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333096060",
            "telephone_number": "954-947-3227",
            "fax_number": "954-947-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 N ANDREWS AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333096060",
            "telephone_number": "954-947-3227",
            "fax_number": "954-947-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJADA PEREZ",
        "first_name": "JEAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-25",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME154926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.