Individual provider Active NPI

Julian Hernandez Carvajal, PA-C

  • Physician Assistant
  • Davenport, IA
National Provider Identifier
1184177412
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
083662 Issued in IA
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-6610
Fax
(563) 421-7719
NPI assigned
Aug 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 083662 IA Primary
Physician Assistant 363A00000X PA61456947 WA
Physician Assistant 363A00000X PA19163 TX

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

PO Box 4028
Rock Island, IL 61204-4028
Phone (563) 355-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address julian.hernandezcarvajal@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, WA, NV, KS, OH, OK, AK8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20160816001360 IA Practitioner - Physician Assistant 4082908959 Reassigns benefits to 2 organizations
I20230227002973 IL Practitioner - Physician Assistant 4082908959 Reassigns benefits to 1 organization
I20230814002047 WA Practitioner - Physician Assistant 4082908959 Reassigns benefits to 1 organization
I20240117001398 NV Practitioner - Physician Assistant 4082908959 Reassigns benefits to 1 organization
I20241009003556 KS Practitioner - Physician Assistant 4082908959 Reassigns benefits to 1 organization
I20250131002783 OH Practitioner - Physician Assistant 4082908959 Reassigns benefits to 1 organization
I20250530002084 OK Practitioner - Physician Assistant 4082908959 Reassigns benefits to 2 organizations
I20251224001263 AK Practitioner - Physician Assistant 4082908959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Oklahoma TCS LLCGroup PAC ID 7315315454, 17 clinicians

Practice addresses (Care Compare)

305 S 5TH St
St Marys Regional Medical Center
Enid, OK 73701-5832
Phone (580) 233-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5257OKMDOrthopaedic Surgery Physician
083662IAMDPhysician Assistant
PA61456947WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ies ER Oklahoma LLC CurrentSince Oct 1, 2025 Accepting new patients
The Metrohealth System Current Accepting new patients
Norton Sound Health Corporation Physician Assistant CurrentSince Nov 3, 2025 Accepting new patients
Hospitalist Medicine Physicians of Oklahoma TCS LLC CurrentSince Mar 28, 2025 Accepting new patients
Norton Sound Health Corporation CurrentSince Nov 3, 2025 Accepting new patients
Genesis Health System CurrentSince Oct 1, 2019 Accepting new patients
Genesis Health System CurrentSince Oct 1, 2019 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Trinity Medical Center Physician Assistant CurrentSince Sep 10, 2025 Accepting new patients
Norton Sound Health Corporation CurrentSince Nov 3, 2025 Accepting new patients
The Metrohealth System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

305 S 5th St
Enid, OK 73701
Phone (580) 233-6100

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: jhernandezcarvajal311709@direct.metrohealth.org
  • Direct secure messaging: jhernandezcarvajal1216935@direct.unitypoint.org
  • Direct secure messaging: julian.hernandezcarvajal@direct.genesishealth.com
  • Direct secure messaging: jhernandezcarvajal800651@direct.peacehealth.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1184177412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4028",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612044028",
            "telephone_number": "563-355-9200",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-6610",
            "fax_number": "563-421-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ CARVAJAL",
        "first_name": "JULIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "083662",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61456947",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julian.hernandezcarvajal@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 E Rusholme St",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.