Individual provider Active NPI

Fernando Duran

  • Physician Assistant
  • Conshohocken, PA
National Provider Identifier
1114624954
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066312 Issued in PA
Practice address
48A E Ridge Pike
Conshohocken, PA 19428-2117
Phone
(484) 243-6735
NPI assigned
Feb 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA066312 PA Primary

Addresses

Primary practice location

48A E Ridge Pike
Conshohocken, PA 19428-2117

Mailing address

2570 48TH St
Sacramento, CA 95817-1541

Other practice location 1

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250408000431 PA Practitioner - Physician Assistant 6901259068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHP MD PLLCGroup PAC ID 6507258423, 45 clinicians

Practice addresses (Care Compare)

10 E Ridge Pike
Conshohocken, PA 19428-2117

180 W Girard Ave
Suite 108
Philadelphia, PA 19123-1660
Phone (267) 319-8047

3680 Aramingo Ave
Philadelphia, PA 19134-4608
Phone (267) 771-3680

48 A E Ridge Pike
Conshohocken, PA 19428-2117
Phone (484) 243-6735

9998 Frankford Ave
Philadelphia, PA 19114-1928
Phone (267) 669-1101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63658CAMDOrthodontics and Dentofacial Orthopedic Dentist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1114624954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 48TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48A E RIDGE PIKE",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282117",
            "telephone_number": "484-243-6735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 S Fairmont Ave",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952405118",
            "country_code": "US",
            "telephone_number": "209-334-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURAN",
        "first_name": "FERNANDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

Sources for this page

Verify at the official NPI Registry.