Individual provider Active NPI

Mary Elizabeth Coronel Hernandez, MD

  • Pediatrics Physician
  • Saipan, MP
National Provider Identifier
1174658124
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0321 Issued in 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
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 0321 MP
Pediatrics Physician 208000000X 0321 MP Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200501001587 GU Practitioner - Pediatric MedicinePractitioner - Pulmonary DiseasePractitioner - Sleep MedicinePractitioner - Hospitalist 3779660295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hospitalist, Pulmonary Disease, Sleep Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Sleep Center, LLCGroup PAC ID 9335215938, 2 clinicians

Practice addresses (Care Compare)

535 N Marine Corps Dr
Suite 1a
Tamuning, GU 96913-4112
Phone (671) 647-6669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0321MPMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Sleep Center, LLC CurrentSince Aug 5, 2020 Accepting new patients

Locations

535 N Marine Corps Dr
Ste 1A
Tamuning, GU 96913
Phone (671) 647-6669

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1174658124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N MARINE CORPS DR",
            "address_2": "STE 1A",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134112",
            "telephone_number": "671-647-6669",
            "fax_number": "671-647-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500409 CHALAN KANOA",
            "address_2": "COMMONWEALTH HEALTH CENTER",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "670-234-8950",
            "fax_number": "670-234-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARY ELIZABETH",
        "middle_name": "CORONEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MP",
            "license": "0321",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MP",
            "license": "0321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saipan, MP

Sources for this page

Verify at the official NPI Registry.