NPIMap

Individual provider Active NPI

Bernardo Fernandez

  • Physician Assistant
  • SLC, UT
National Provider Identifier
1093367344
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11952470-1206 Issued in UT
Practice address
2641 E Stringham Ave Apt 303C
SLC, UT 84109-3984
Phone
(559) 906-2823
NPI assigned
Jul 16, 2019
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11952470-1206 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2641 E Stringham Ave Apt 303C
SLC, UT 84109-3984

Mailing address

2641 E Stringham Ave Apt 303C
SLC, UT 84109-3984
Phone (559) 906-2823

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BFERNANDEZ326810@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201023001163 UT Practitioner - Physician Assistant 9133549587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Oct 1, 2020 Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2022 Accepting new patients
University of Utah Community Physicians Group Past Accepting new patients

Locations

1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

10433 S Redwood Rd
South Jordan, UT 84095
Phone (801) 260-1919

10433 S Redwood Rd
Ste B
South Jordan, UT 84095
Phone (801) 260-1919

Interoperability endpoints

  • Direct secure messaging: bfernandez326810@direct.med.utah.edu
  • Direct secure messaging: bfernandez575841@direct.med.utah.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1093367344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 E STRINGHAM AVE APT 303C",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841093984",
            "telephone_number": "559-906-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 E STRINGHAM AVE APT 303C",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841093984",
            "telephone_number": "559-906-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "BERNARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11952470-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BFERNANDEZ326810@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.