Individual provider Active NPI

Edwin Geordy Perez, MD

  • General Practice Physician
  • Guaynabo, PR
National Provider Identifier
1922405539
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18940 Issued in PR
Practice address
C/4 a-17
Urb. Santa Paula
Guaynabo, PR 00969-4606
Phone
(787) 405-4010
NPI assigned
Nov 25, 2014
Last updated
Nov 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18940 PR Primary

Addresses

Primary practice location

C/4 a-17
Urb. Santa Paula
Guaynabo, PR 00969-4606

Mailing address

Calle 4 a-17
Urb. Santa Paula
Guaynabo, PR 00969-4606
Phone (787) 405-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20190320003090 PR Practitioner - General Practice 1759621196 Reassigns benefits to 1 organization
Practice locations: Guaynabo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18940PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HPM Foundation Inc CurrentSince Jun 1, 2022 Accepting new patients

Locations

2020 Ave Borinquen
Santurce, PR 00915

Organizations & group practices 2

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": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1922405539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 4 A-17",
            "address_2": "URB. SANTA PAULA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694606",
            "telephone_number": "787-405-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/4 A-17",
            "address_2": "URB. SANTA PAULA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694606",
            "telephone_number": "787-405-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EDWIN",
        "middle_name": "GEORDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-25",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.