Individual provider Active NPI

Aditya Mani Perumal, PHARM D

  • Pharmacist
  • St Augustine, FL
National Provider Identifier
1932806817
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PSI37987 Issued in FL
Practice address
1201 Arapaho Ave
Saint Augustine, FL 32084-4203
Phone
(904) 829-9919
Fax
(904) 829-2617
NPI assigned
Feb 13, 2023
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PSI37987 FL Primary

Addresses

Primary practice location

1201 Arapaho Ave
Saint Augustine, FL 32084-4203

Mailing address

140 Historic Brick LN
St Augustine, FL 32095-8020
Phone (904) 386-5975

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PSI37987FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Care Inc CurrentSince Feb 19, 2023 Accepting new patients

Locations

1201 Arapaho Ave
St Augustine, FL 32084
Phone (904) 794-7000

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1932806817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HISTORIC BRICK LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958020",
            "telephone_number": "904-386-5975",
            "fax_number": "904-829-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ARAPAHO AVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844203",
            "telephone_number": "904-829-9919",
            "fax_number": "904-829-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUMAL",
        "first_name": "ADITYA",
        "middle_name": "MANI",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PSI37987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.