Active NPI
Fernando J Perez, MD
- Emergency Medicine Physician
- Savannah, GA
National Provider Identifier
1962445924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 029228
- Practice address
- 5 Executive Cir
Savannah, GA 31406-3345 - Phone
- (912) 355-2400
- Fax
- (912) 355-5324
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 029228 | GA | Primary |
Addresses
Primary practice location
5 Executive Cir
Savannah, GA 31406-3345
Mailing address
5 Executive Cir
Savannah, GA 31406-3345
Phone (912) 355-2400
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000410946E | Medicaid | GA | |
| 000410946 | Medicaid | GA | |
| 000410946L | Medicaid | GA | |
| 000410946D | Medicaid | GA | |
| 000410946J | Medicaid | GA | |
| 10058850 | Other | GA | AMERIGIGROUIP |
| 000410946K | Medicaid | GA | |
| G29228 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070530000004 | GA | Practitioner - Emergency Medicine | 1951363704 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029228 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Baxley and Appling County Hospital Authority | Past | Accepting new patients | |
| Georgia Emergency Associates Immediate Care Center | Past | Accepting new patients | |
| Advanced Pediatric Specialists LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Savannah, GA
- NPI 1073046397
-
- Rural Health Clinic/Center
- Baxley, GA
- NPI 1073752143
-
- General Practice Physician
- Bluffton, SC
- NPI 1699147421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1962445924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 EXECUTIVE CIR",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314063345",
"telephone_number": "912-355-2400",
"fax_number": "912-355-5324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 EXECUTIVE CIR",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314063345",
"telephone_number": "912-355-2400",
"fax_number": "912-355-5324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "FERNANDO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "029228",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946L",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946J",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGIGROUIP",
"identifier": "10058850",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000410946K",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G29228",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.