Tanya Monique Perez, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

11050 Mount Belvedere Blvd
USA Meddac/Credentials
Fort Drum, NY 13602-5438

Phone

(315) 772-4025

Fax

(315) 772-9498

NPI assigned

Jan 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1881672350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 BROADWAY AVE E",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013828",
            "telephone_number": "315-681-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "USA MEDDAC/CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TANYA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory John Pataky, APA-C
• David Andrew Paul
• Dean C Pedersen, M.D.
• Gregory H Pelcak, P.A.
• Samantha Renee Pelcak, PH.D.
• Brandon Anthony Perroots, DDS
• Jennifer Louise Petersen, NURSE PRACTITIONER
• Renee Jean Petitto, D.C
• Maria Pettit
• Julie Pickett, OD

• Medical Physician Assistant in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.