Andre Peri, PHD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6146 Issued in MN

Practice address

2001 Bloomington Ave
Minneapolis, MN 55404-3074

Phone

(612) 721-9800

NPI assigned

Oct 5, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of MinnesotaGroup PAC ID 7416856059, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Regents of the University of Minnesota

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  Care Compare group NPD
• Regents of the University of Minnesota

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1982988259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10427 BROWN FARM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474926",
            "telephone_number": "301-213-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074",
            "telephone_number": "612-721-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERI",
        "first_name": "ANDRE",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-05",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000841",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05040",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary David Perez, MD
• Perfect Balance Autism Center
• Perfection Care Associates LLC
• Performance Acupuncture LLC
• Penny A Pergament, PSY.D.
• Priya Periakaruppan
• Rameshkumar Periyasamy, M.D
• Dru Perkins, DMD
• Elizabeth J Perkins, PA
• Joanna Lee Perkins, MD MS

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.