Individual provider Active NPI

Christine Marie Fernandez, PA

  • Medical Physician Assistant
  • Rancho Mirage, CA
National Provider Identifier
1275104705
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA59675 Issued in CA
Practice address
72780 Country Club Dr Ste 100
Rancho Mirage, CA 92270-4150
Phone
(760) 773-9750
Fax
(760) 773-9294
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA59675 CA Primary

Addresses

Primary practice location

72780 Country Club Dr Ste 100
Rancho Mirage, CA 92270-4150

Mailing address

2285 Corporate Cir
Ste 200
Henderson, NV 89074-7759
Phone (702) 360-2763

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
I20210914002211 CA Practitioner - Physician Assistant 3072919265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

340 S Farrell Dr
Suite A205
Palm Springs, CA 92262-7931
Phone (760) 325-5588

72785 Frank Sinatra Dr
Suite 101
Rancho Mirage, CA 92270-3207
Phone (760) 969-5900

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
59675CAMDGeneral Practice Dentistry
PA59675CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc CurrentSince Feb 15, 2022 Accepting new patients

Locations

340 S Farrell Dr
Ste A205
Palm Springs, CA 92262
Phone (760) 325-5588

72785 Frank Sinatra Dr
Rancho Mirage, CA 92270
Phone (760) 969-5900

72785 Frank Sinatra Dr
Ste 101
Rancho Mirage, CA 92270
Phone (760) 776-8637

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1275104705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR STE 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704150",
            "telephone_number": "760-773-9750",
            "fax_number": "760-773-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA59675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.