Active NPI
Oscar Adrian Perez, PA-C
- Medical Physician Assistant
- Granite City, IL
National Provider Identifier
1851177232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085009943
- Practice address
- 2166 Madison Ave
Granite City, IL 62040-4700 - Phone
- (618) 452-3301
- Fax
- (618) 452-3312
- NPI assigned
- Sep 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085009943 | IL | Primary |
Addresses
Primary practice location
2166 Madison Ave
Granite City, IL 62040-4700
Mailing address
2166 Madison Ave
Granite City, IL 62040-4700
Phone (618) 452-3301
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oscar.perez.1@9559.direct.athenahealth.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Lincoln Memorial University Medical Department, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2001 State St
East Saint Louis, IL 62205-1803
Phone (618) 271-9191
2166 Madison Ave
Granite City, IL 62040-4700
Phone (618) 332-0953
Hospital & facility affiliations
- Gateway Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Healthcare Foundation Inc | Current | Accepting new patients | |
| Southern Illinois Healthcare Foundation, Inc. | Current | Accepting new patients | |
| Southern Illinois Healthcare Foundation Inc | Past | Accepting new patients |
Locations
2001 State St
East St Louis, IL 62205
Phone (618) 271-0204
2166 Madison Ave
Granite City, IL 62040
Phone (618) 452-3301
2041 Goose Lake Rd
Sauget, IL 62206
Interoperability endpoints
- oscar.perez.1@9559.direct.athenahealth.com
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.
-
- Federally Qualified Health Center (FQHC)
- Centreville, IL
- NPI 1609813500
-
- Federally Qualified Health Center (FQHC)
- Waterloo, IL
- NPI 1821813247
-
- Federally Qualified Health Center (FQHC)
- Bunker Hill, IL
- NPI 1659506939
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Granite City, IL
- NPI 1326765884
-
- Urgent Care Clinic/Center
- Glen Carbon, IL
- NPI 1700586344
Hospital
-
- Urgent Care Clinic/Center
- Columbia, IL
- NPI 1982304523
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1851177232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2166 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404700",
"telephone_number": "618-452-3301",
"fax_number": "618-452-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2166 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404700",
"telephone_number": "618-452-3301",
"fax_number": "618-452-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "OSCAR",
"middle_name": "ADRIAN",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-01",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085009943",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "oscar.perez.1@9559.direct.athenahealth.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "2166 Madison Ave",
"city": "Granite City",
"state": "IL",
"country_code": "US",
"postal_code": "620404700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.