Individual provider Active NPI

Luis E Hernandez

  • Gerontology Nurse Practitioner
  • Miami Springs, FL
National Provider Identifier
1174230429
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG06220084 Issued in FL
Practice address
4471 NW 36TH St Ste 232
Miami Springs, FL 33166-7289
Phone
(786) 391-3913
NPI assigned
Nov 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG06220084 FL Primary

Addresses

Primary practice location

4471 NW 36TH St Ste 232
Miami Springs, FL 33166-7289

Mailing address

4471 NW 36TH St Ste 232
Miami Springs, FL 33166-7289
Phone (786) 391-3913

Other identifiers 1

IdentifierTypeStateIssuer
1881229920OtherFLNP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Luis.H07@outlook.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AG06220084FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Assured Home Health, Inc CurrentSince Dec 18, 2022 Accepting new patients

Locations

4471 NW 36th St
Ste 232
Miami Springs, FL 33166
Phone (786) 391-3913

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": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1174230429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 NW 36TH ST STE 232",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667289",
            "telephone_number": "786-391-3913",
            "fax_number": "786-409-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 NW 36TH ST STE 232",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667289",
            "telephone_number": "786-391-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LUIS",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "AG06220084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "1881229920",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Luis.H07@outlook.com",
            "affiliation": "N",
            "address_1": "4471 NW 36th St Ste 232",
            "city": "Miami Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331667289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.