Individual provider Active NPI

Alicia Ann Hernandez, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1083477228
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2024-0005 Issued in NM
Practice address
4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone
(505) 596-2200
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA2024-0005 NM
Physician Assistant 363A00000X PA2024-0005 NM Primary

Addresses

Primary practice location

4515 Coors Blvd NW
Albuquerque, NM 87120-3699

Mailing address

2815 Gunnison Dr Apt 201
Columbus, OH 43228-8985
Phone (419) 789-1879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240327000201 NM Practitioner - Physician Assistant 5193162006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113-1718
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2024-0005NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Apr 14, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

8312 Kaseman Ct NE
Albuquerque, NM 87110
Phone (505) 291-2200

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

Interoperability endpoints

  • Direct secure messaging: ahernandez246993@direct.phs.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1083477228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 GUNNISON DR APT 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432288985",
            "telephone_number": "419-789-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203699",
            "telephone_number": "505-596-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ALICIA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2024-0005",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.