Individual provider Active NPI

Nydia L. Perez, MD

  • Internal Medicine Physician
  • Gurabo, PR
National Provider Identifier
1831120286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12141 Issued in PR
Practice address
111 Calle Malagueta
Urb. Ciudad Jardin de Gurabo
Gurabo, PR 00778-9660
Phone
(787) 737-1764
NPI assigned
Jul 5, 2006
Sex
Female
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
Internal Medicine Physician 207R00000X 12141 PR Primary

Addresses

Primary practice location

111 Calle Malagueta
Urb. Ciudad Jardin de Gurabo
Gurabo, PR 00778-9660

Mailing address

Malagueta St. #111
Urb. Ciudad Jardin de Gurabo
Gurabo, PR 00778
Phone (787) 737-1764

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
I20070823000733 PR Practitioner - Internal Medicine 7214029040 Practice locations: San Lorenzo, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

San Lorenzo Mall Local
Suite 42
San Lorenzo, PR 00754
Phone (787) 561-7901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12141FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831120286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MALAGUETA ST. #111",
            "address_2": "URB. CIUDAD JARDIN DE GURABO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-737-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CALLE MALAGUETA",
            "address_2": "URB. CIUDAD JARDIN DE GURABO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007789660",
            "telephone_number": "787-737-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NYDIA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.