Individual provider Active NPI

Gabriel Hernandez, NP

  • Nurse Practitioner
  • Calexico, CA
National Provider Identifier
1164043782
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95009118 Issued in CA
Practice address
223 W Cole Blvd
Calexico, CA 92231-9722
Phone
(760) 357-2020
Fax
(760) 355-9521
NPI assigned
May 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95009118 CA Primary

Addresses

Primary practice location

223 W Cole Blvd
Calexico, CA 92231-9722

Mailing address

223 W Cole Blvd
Calexico, CA 92231-9722
Phone (607) 357-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200617002294 CA Practitioner - Nurse Practitioner 8224450481 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyson Medical IncGroup PAC ID 3072870112, 21 clinicians

Practice addresses (Care Compare)

2026 N Imperial Ave
Suite C
El Centro, CA 92243-1607
Phone (760) 592-4351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009118CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tyson Medical Inc CurrentSince Mar 2, 2025 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Jun 16, 2025 Accepting new patients
Imperial Valley Family Care Medical Group Apc CurrentSince Mar 1, 2020 Accepting new patients
BL Anderson Medical Corporation CurrentSince Sep 5, 2024 Accepting new patients
Clinicas de Salud del Pueblo, Inc. CurrentSince Jun 16, 2025 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Tyson Medical Inc CurrentSince Mar 2, 2025 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Mar 1, 2020 Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

630 S Brawley Ave
Ste 10
Brawley, CA 92227
Phone (760) 623-1202

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

400 Mary Ave
Calexico, CA 92231

400 Mary Ave
Ste 2
Calexico, CA 92231
Phone (760) 592-4351

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

1044 Cherry Valley Blvd
#430
Calimesa, CA 92320
Phone (760) 592-4351

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

2026 N Imperial Ave
Ste C
El Centro, CA 92243
Phone (760) 592-4351

1501 Ocotillo Dr
Ste C
El Centro, CA 92243
Phone (760) 353-6363

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

10890 Thornmint Rd
Ste 202
San Diego, CA 92127
Phone (855) 745-8400

Interoperability endpoints

  • Direct secure messaging: gabriel.hernandez.p1@direct.cdsdp.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EBDDBD/Endpoint/EBDDBD

Organizations & group practices 8

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": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1164043782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 W COLE BLVD",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922319722",
            "telephone_number": "607-357-2020",
            "fax_number": "760-355-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W COLE BLVD",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922319722",
            "telephone_number": "760-357-2020",
            "fax_number": "760-355-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GABRIEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calexico, CA

Sources for this page

Verify at the official NPI Registry.