Individual provider Active NPI

Robert G Perry, M.D

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1831245554
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME94381 Issued in FL
Practice address
2250 NW 136 Ave Ste 100
Pembroke Pines, FL 33028-2586
Phone
(954) 302-7960
Fax
(546) 285-0849
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 ME94381 FL Primary

Addresses

Primary practice location

2250 NW 136 Ave Ste 100
Pembroke Pines, FL 33028-2586

Mailing address

2250 NW 136 Ave Ste 100
Pembroke Pines, FL 33028-2586
Phone (954) 302-7960

Other practice location 1

12105 Taft St
Pembroke Pines, FL 33026-1957
Phone (954) 302-7960

Other identifiers 1

IdentifierTypeStateIssuer
ME94381OtherFLFLORIDA LICENSE

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
I20100302000504 FL Practitioner - Internal Medicine 5991793846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12105 Taft St
Pembroke Pines, FL 33026-1957
Phone (954) 302-7960

Hospital & facility affiliations

  • Memorial Home Health Services Home health agency, Hollywood, FL, CCN 107444
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rgpmd, LLC Internal Medicine CurrentSince Sep 24, 2013 Accepting new patients
Gramercy Cardiac Diagnostic Services, P.C. Past Accepting new patients
Lower Manhattan Gastroenterology Group, P.C. Past Accepting new patients

Locations

12105 Taft St
Pembroke Pines, FL 33026
Phone (954) 302-7960

2250 NW 136th Ave
Ste 100
Pembroke Pnes, FL 33028
Phone (954) 302-7960

Organizations & group practices 3

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 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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831245554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW 136 AVE STE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282586",
            "telephone_number": "954-302-7960",
            "fax_number": "954-628-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW 136 AVE STE 100",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282586",
            "telephone_number": "954-302-7960",
            "fax_number": "546-285-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12105 Taft St",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330261957",
            "country_code": "US",
            "telephone_number": "954-302-7960",
            "fax_number": "954-628-5084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-03-07",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ME94381",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.