Individual provider Active NPI

Wilmer Perez, MD

  • Pulmonary Disease Physician
  • Federal Way, WA
National Provider Identifier
1922037589
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD00048425 Issued in WA
Practice address
34503 9TH Ave S Ste 230
Federal Way, WA 98003-8726
Phone
(253) 838-3103
Fax
(360) 744-6270
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD00048425 WA
Pulmonary Disease Physician 207RP1001X MD00048425 WA Primary

Addresses

Primary practice location

34503 9TH Ave S Ste 230
Federal Way, WA 98003-8726

Mailing address

34503 9TH Ave S Ste 230
Federal Way, WA 98003-8726
Phone (253) 838-3103

Other identifiers 2

IdentifierTypeStateIssuer
1922037589MedicaidWA
2070515MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wperez590483@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20200915001870 OR Practitioner - Sleep Medicine 5395795272 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00048425WAMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Health Care System CurrentSince Sep 1, 2020 Accepting new patients
Lutheran Hospital Association of the San Luis Valley Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Wilmer Perez MD PC Pulmonary Disease PastSince Feb 1, 2005 Accepting new patients
Walsen Clinic Past Accepting new patients
Complete Foot Care, P.C. Past Accepting new patients

Locations

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

Interoperability endpoints

  • Direct secure messaging: wperez590483@fhsce.catholichealth.net
  • Direct secure messaging: wperez475084@direct.lhs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1922037589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE S STE 230",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038726",
            "telephone_number": "253-838-3103",
            "fax_number": "360-744-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE S STE 230",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038726",
            "telephone_number": "253-838-3103",
            "fax_number": "360-744-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "WILMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD00048425",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00048425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922037589",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070515",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wperez590483@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34503 9th Ave S Ste 230",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980038726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.