Individual provider Active NPI

Dilennys Mercedes Perez, FNP

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1881235174
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN02759 Issued in RI
Practice address
712 Broad St
Providence, RI 02907-1465
Phone
(401) 233-5060
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN02759 RI Primary
Family Medicine Physician 207Q00000X RN290002 GA

Addresses

Primary practice location

712 Broad St
Providence, RI 02907-1465

Mailing address

48 Gloucester St
Providence, RI 02908-1408
Phone (401) 749-6844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324001137 RI Practitioner - Nurse Practitioner 6709219728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN290002GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - Ri Physicians Group, PC Family Medicine CurrentSince Mar 14, 2022 Accepting new patients

Locations

712 Broad St
Providence, RI 02907
Phone (401) 233-5060

300 Quaker Ln
Warwick, RI 02886
Phone (401) 233-5051

Organizations & group practices 1

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1881235174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 GLOUCESTER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029081408",
            "telephone_number": "401-749-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071465",
            "telephone_number": "401-233-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DILENNYS",
        "middle_name": "MERCEDES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN02759",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN290002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.