Perry Dave, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS15109 Issued in FL

Practice address

4878 Waters Gate Dr
Tavares, FL 32778-6208

Phone

(412) 664-2167

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Ipc Hospitalist Physicians of New Jersey PC

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1639303159
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1831535491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4878 WATERS GATE DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327786208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4878 WATERS GATE DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327786208",
            "telephone_number": "412-664-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "PERRY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15107",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Dacosta, FNP-C
• Andrew Dakkak, MD
• Raquel Dallas
• Laura Elizabeth Dalley, ARNP
• Michaela Daniels
• David F Fernandez, MD, PA
• David L. Frerking D.C.P.a.
• Chalandra Davis
• Dynasty Davis
• Sandra F Dawson, NP

• Internal Medicine Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.