Individual provider Active NPI

Roberto Hernandez, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1285274530
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11005657 Issued in FL
Practice address
3769 SE Milwaukie Ave
Portland, OR 97202-3804
Phone
(305) 497-0272
NPI assigned
Jan 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN11005657 FL Primary
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X APRN11005657 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202006086NP-PP OR

Addresses

Primary practice location

3769 SE Milwaukie Ave
Portland, OR 97202-3804

Mailing address

10051 SW 46TH St
Miami, FL 33165-5709
Phone (305) 497-0272

Other practice location 1

1700 SW 257th Ave
Troutdale, OR 97060-1900
Phone (503) 669-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231023000204 TX Practitioner - Nurse Practitioner 2062841596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11005657FLMDPsychiatric/Mental Health Nurse Practitioner
202006086NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summerskyy Health, LLC CurrentSince Feb 9, 2025 Accepting new patients
Florida Behavioral Center, Inc Single Specialty CurrentSince Jun 14, 2025 Accepting new patients
Navarro County Ambulatory Care Association Single Specialty CurrentSince Dec 6, 2023 Accepting new patients
Corsicana-Navarro County Public Health District CurrentSince Dec 6, 2023 Accepting new patients
Cye Ga LLC Single Specialty CurrentSince Jun 16, 2023 Accepting new patients
Tmo Medical and Rehab Single Specialty Past Accepting new patients

Locations

3501 Del Prado Blvd S
Ste 303
Cape Coral, FL 33904
Phone (239) 317-0265

618 N Main St
Corsicana, TX 75110
Phone (903) 874-6711

2626 S Loop W
Ste 435
Houston, TX 77054
Phone (281) 936-0047

2626 S Loop W
Ste 415
Houston, TX 77054
Phone (281) 936-0047

Interoperability endpoints

  • Direct secure messaging: roberto.hernandez@wwmp.eclinicaldirectplus.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1285274530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 SW 46TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655709",
            "telephone_number": "305-497-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3769 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023804",
            "telephone_number": "305-497-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 SW 257th Ave",
            "address_purpose": "LOCATION",
            "city": "Troutdale",
            "state": "OR",
            "postal_code": "970601900",
            "country_code": "US",
            "telephone_number": "503-669-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ROBERTO",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11005657",
            "primary": true
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "FL",
            "license": "APRN11005657",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202006086NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.