Individual provider Active NPI

Nicolas Hernandez, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • San Juan, PR
National Provider Identifier
1275637332
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
12019 Issued in PR
Practice address
El Monte Mall Ste 302
San Juan, PR 00918-4257
Phone
(787) 764-0937
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 12019 PR Primary

Addresses

Primary practice location

El Monte Mall Ste 302
San Juan, PR 00918-4257

Mailing address

El Monte Mall Ste 302
San Juan, PR 00918-4257
Phone (787) 764-0937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20150606000128 PR Practitioner - Psychiatry 6204157910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Ponce de Leon Ave
715 Stop 37.5
San Juan, PR 00918-1000
Phone (787) 771-7934

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12019PRMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince May 1, 2015 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince May 1, 2015 Accepting new patients

Locations

715 Ave Ponce de Leon
#375
San Juan, PR 00917
Phone (787) 717-6763

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

Interoperability endpoints

  • Direct secure messaging: nicolas.hernandez@auxiliomutuo.ikm.direct-ci.com

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.

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275637332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EL MONTE MALL STE 302",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184257",
            "telephone_number": "787-764-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EL MONTE MALL STE 302",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184257",
            "telephone_number": "787-764-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "PR",
            "license": "12019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.