Individual provider Active NPI

Randy Jacob Hernandez, PT

  • Physical Therapist
  • Metairie, LA
National Provider Identifier
1083749220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05029 Issued in LA
Practice address
111 Veterans Blvd
Suite 470
Metairie, LA 70005
Phone
(504) 834-9259
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05029 LA Primary

Addresses

Primary practice location

111 Veterans Blvd
Suite 470
Metairie, LA 70005

Mailing address

1508 Francis Ave
Metairie, LA 70003-4648
Phone (504) 885-9838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022000029 LA Practitioner - Physical Therapist in Private Practice 7618938721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Movement Science CenterGroup PAC ID 4587658687, 13 clinicians

Practice addresses (Care Compare)

321 Veterans Memorial Blvd
Suite 100
Metairie, LA 70005-3060
Phone (504) 834-9259

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
80
Improvement activities
40
Cost
71.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05029LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Movement Science Center Physical Therapist CurrentSince Jan 1, 2001 Accepting new patients
The Movement Science Center PastSince Jul 15, 2004 Accepting new patients

Locations

1201 Ochsner Blvd
Ste A
Covington, LA 70433
Phone (985) 801-7145

100 Bon Temps Roule
Ste A
Mandeville, LA 70471
Phone (985) 792-0225

321 Veterans Memorial Blvd
Ste 100
Metairie, LA 70005
Phone (504) 834-9259

3838 N Causeway Blvd
Ste 900
Metairie, LA 70002
Phone (504) 834-1084

Organizations & group practices 2

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083749220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 FRANCIS AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700034648",
            "telephone_number": "504-885-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VETERANS BLVD",
            "address_2": "SUITE 470",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70005",
            "telephone_number": "504-834-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "RANDY",
        "middle_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "05029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.