Mary Elizabeth Coronel Hernandez, MD
Individual provider Active NPI Pediatrics Physician · Saipan, MP
NPI 1174658124 · NPPES record last updated Dec 9, 2020
Key facts
- NPI
- 1174658124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 0321 (MP)
- Practice address
- 500409 Chalan Kanoa
Commonwealth Health Center
Saipan, MP 96950 - Phone
- (670) 234-8950
- Fax
- (670) 234-8700
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Guam Sleep Center, LLC
Practice addresses (Care Compare)
535 N Marine Corps Dr
Suite 1a
Tamuning, GU 96913-4112
Phone (671) 647-6669
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200501001587 | GU | Practitioner - Pediatric Medicine |
3779660295 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0321 | MP | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guam Sleep Center, LLC | Current |
Accepting new patients |
Locations
535 N Marine Corps Dr
Ste 1A
Tamuning, GU 96913
Phone (671) 647-6669
415 Chalan San Antonio
Ste 202
Tamuning, GU 96913
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 0321 | MP | |
| Pediatrics Physician | 208000000X | 0321 | MP | Yes |
Addresses
Primary practice location
500409 Chalan Kanoa
Commonwealth Health Center
Saipan, MP 96950
Mailing address
535 N Marine Corps Dr
Ste 1a
Tamuning, GU 96913-4112
Phone (671) 647-6669
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 92873529 | Other | CO | COLORADO MEDICAID PROGRAM |
Other providers in Saipan, MP
- Michael Hart
- Health Plus, Inc.
- Health Professional Corporation
- Health Professional Corporation
- Healthy Farmers, LLC
- Hippocrates Medical Equipment and Services
- Hippocrates Sleep Disorder Diagnostic Center
- Larry Borja Hocog
- Anneka Maria Hofschneider
- Amanda Rae Holloway
All providers in Saipan, MP · Pediatrics Physician in Northern Mariana Islands
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.