Individual provider Active NPI

Lourdes R Perez, MD

  • Hospitalist Physician
  • Ponce, PR
National Provider Identifier
1982694766
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
9932 Issued in PR
Practice address
Calle Concordia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589
Phone
(787) 844-3067
NPI assigned
Oct 24, 2005
Last updated
Mar 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 9932 PR Primary

Addresses

Primary practice location

Calle Concordia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589

Mailing address

Calle Concordia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589
Phone (787) 844-3067

Other identifiers 2

IdentifierTypeStateIssuer
89965PEOtherSSS
060999OtherCHEZ AZUL

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
I20120420000366 PR Practitioner - General Practice 3173784071 Practice locations: Ponce, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9932PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1982694766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE CONCORDIA #8118",
            "address_2": "GALENA PROFESIONAL SUITE 105",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "787-844-3067",
            "fax_number": "787-844-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE CONCORDIA #8118",
            "address_2": "GALENA PROFESIONAL SUITE 105",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "787-844-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LOURDES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PR",
            "license": "9932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "89965PE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHEZ AZUL",
            "identifier": "060999",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.