Sergio Miguel Fernandez, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60346231 Issued in WA

Practice address

501 SE 172ND Ave Ste 130
Vancouver, WA 98684

Phone

(360) 882-2778

Fax

(360) 604-1772

NPI assigned

Apr 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Urgent Care NW Gresham PC

  • Urgent Care Clinic/Center
  • Gresham, OR
  • NPI 1336128321
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1083957468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 130",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 N Devine Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986616979",
            "country_code": "US",
            "telephone_number": "360-952-4457",
            "fax_number": "360-828-7409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 N Devine Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986616979",
            "country_code": "US",
            "telephone_number": "360-952-4457",
            "fax_number": "360-828-7409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "SERGIO",
        "middle_name": "MIGUEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60346231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fern & Fae Massage
• Fern Acupuncture LLC
• Shania Fernandez Lopez
• Michael Josue Fernandez, LMHC
• Rachel Fernandez
• Caitlin Jean Fernhoff
• Jade Ferra
• Eric D Ferraris, MD
• Jenika Ferretti-Gallon, MD
• Christopher Benjamin Ferrin, PHARMD

• Family Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.