Individual provider Active NPI

Glauber Bruno Pereira, MD, PHD

  • Pulmonary Disease Physician
  • Rogers, AR
National Provider Identifier
1841610037
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E-12963 Issued in AR
Practice address
2708 S Rife Medical LN Ste T20
Rogers, AR 72758-1469
Phone
(479) 338-3089
NPI assigned
Apr 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X E-12963 AR
Pulmonary Disease Physician 207RP1001X E-12963 AR Primary

Addresses

Primary practice location

2708 S Rife Medical LN Ste T20
Rogers, AR 72758-1469

Mailing address

2708 S Rife Medical LN Ste T20
Rogers, AR 72758-1469
Phone (479) 338-3080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200811003698 AR Practitioner - Pulmonary Disease 1456584846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Arkansas College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

2708 S Rife Medical LN
Suite T30
Rogers, AR 72758-1458
Phone (479) 338-3999

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-12963ARMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 10, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 10, 2020 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste T20
Rogers, AR 72758
Phone (479) 338-3080

Interoperability endpoints

  • Direct secure messaging: gpereira1056690@directc.mercy.net

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 2

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": "1398470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1841610037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE T20",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581469",
            "telephone_number": "479-338-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE T20",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581469",
            "telephone_number": "479-338-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "GLAUBER",
        "middle_name": "BRUNO",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-26",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AR",
            "license": "E-12963",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E-12963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.