NPIMap

Individual provider Active NPI

Clifford C Perera, MD

  • Psychiatry Physician
  • Cuyahoga Falls, OH
National Provider Identifier
1861407603
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35037134P Issued in OH
Practice address
3033 State Rd
Suite 204
Cuyahoga Falls, OH 44223-3614
Phone
(330) 928-6780
Fax
(330) 928-6785
NPI assigned
Jul 30, 2006
Last updated
Mar 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35037134P OH Primary

Addresses

Primary practice location

3033 State Rd
Suite 204
Cuyahoga Falls, OH 44223-3614

Mailing address

3033 State Rd
Suite 204
Cuyahoga Falls, OH 44223-3614
Phone (330) 928-6780

Other identifiers 1

IdentifierTypeStateIssuer
0295907MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35037134POHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Retina Group of Northeast Ohio Inc Past Accepting new patients
Kent Management Group Inc Psychiatry Past Accepting new patients
Health Care Center Physicians, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1861407603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 STATE RD",
            "address_2": "SUITE 204",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233614",
            "telephone_number": "330-928-6780",
            "fax_number": "330-928-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 STATE RD",
            "address_2": "SUITE 204",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233614",
            "telephone_number": "330-928-6780",
            "fax_number": "330-928-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "CLIFFORD",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35037134P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0295907",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.