NPIMap

Individual provider Active NPI

Gabriel A. Hernandez, M.D.

  • Psychiatry Physician
  • Las Cruces, NM
National Provider Identifier
1003806472
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
NM2003-0024 Issued in NM
Practice address
1505 S. Don Roser Dr.
Suite a
Las Cruces, NM 88011
Phone
(575) 521-3388
Fax
(575) 521-4023
NPI assigned
Oct 26, 2005
Last updated
Sep 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2003-0024 NM
Psychiatry Physician 2084P0800X NM2003-0024 NM Primary

Addresses

Primary practice location

1505 S. Don Roser Dr.
Suite a
Las Cruces, NM 88011

Mailing address

1505 S. Don Roser Dr.
Suite a
Las Cruces, NM 88011
Phone (575) 521-3388

Other identifiers 1

IdentifierTypeStateIssuer
99930722MedicaidNM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NM2003-0024NMMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates Inc Past Accepting new patients
New Mexico Health Options Past Accepting new patients
Southern New Mexico Human Development, Inc. Past Accepting new patients
Border Area Mental Health Services, Inc PastSince Oct 1, 2018 Accepting new patients

Organizations & group practices 5

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1003806472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 S. DON ROSER DR.",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-521-3388",
            "fax_number": "575-521-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S. DON ROSER DR.",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-521-3388",
            "fax_number": "575-521-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GABRIEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "2003-0024",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "NM2003-0024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99930722",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.