Individual provider Active NPI

Edward Paul Hernandez, O.D.

  • Optometrist
  • La Puente, CA
National Provider Identifier
1306995691
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
08489T Issued in CA
Practice address
15330 Amar Rd Ste a
La Puente, CA 91744-2001
Phone
(626) 961-0432
Fax
(626) 333-7741
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 08489T CA Primary

Addresses

Primary practice location

15330 Amar Rd Ste a
La Puente, CA 91744-2001

Mailing address

15330 Amar Rd Ste a
La Puente, CA 91744-2001
Phone (626) 961-0432

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000891 CA Practitioner - Optometry 8527137694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08489TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward P. & Diane M. Hernandez Optometrist CurrentSince May 14, 1990 Accepting new patients
DRS. Edward P. and Diane M. Hernandez, O.D. Optometrist CurrentSince May 14, 1990 Accepting new patients
DRS. Edward P. and Diane M. Hernandez, O.D. Optometrist PastSince Apr 20, 1987 Accepting new patients

Locations

1235 Buena Vista St
Duarte, CA 91010
Phone (626) 359-8145

15330 Amar Rd
Ste A
La Puente, CA 91744
Phone (626) 961-0432

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1306995691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15330 AMAR RD STE A",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442001",
            "telephone_number": "626-961-0432",
            "fax_number": "626-333-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15330 AMAR RD STE A",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442001",
            "telephone_number": "626-961-0432",
            "fax_number": "626-333-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "EDWARD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "08489T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.