Individual provider Active NPI

Katherine Hernandez, PA-C

  • Physician Assistant
  • Doral, FL
National Provider Identifier
1316683824
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115740 Issued in FL
Practice address
3470 NW 82ND Ave Ste 111
Doral, FL 33122-1026
Phone
(786) 272-2500
Fax
(786) 353-2562
NPI assigned
May 8, 2022
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115740 FL Primary

Addresses

Primary practice location

3470 NW 82ND Ave Ste 111
Doral, FL 33122-1026

Mailing address

15537 SW 170TH Ter
Miami, FL 33187-7789
Phone (786) 925-8962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220912003861 FL Practitioner - Physician Assistant 3577948520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of Florida, P.a.Group PAC ID 1153367107, 54 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

3470 NW 82ND Ave
Suite 111
Doral, FL 33122-1026
Phone (786) 272-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115740FLMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/bf8f05ba-6e12-4216-9197-5290cecb808c/

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.

NPI Registry JSON

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

{
    "created_epoch": "1651968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1316683824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15537 SW 170TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331877789",
            "telephone_number": "786-925-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 NW 82ND AVE STE 111",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221026",
            "telephone_number": "786-272-2500",
            "fax_number": "786-353-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-08",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.