Miguel R Hernandez, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5127 Issued in AZ

Practice address

3050 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-7804

Phone

(623) 935-5505

Fax

(653) 935-5551

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Capptcg, LLC

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1922498500
  Medicare reassignment NPD
• Canyon State Physical Therapy

  • Physical Therapist
  • Glendale, AZ
  • NPI 1225087158
  NPD (past)
• Olympic Physical Therapy, Inc

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1790733525
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1366566689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32490",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642490",
            "telephone_number": "602-230-4478",
            "fax_number": "602-230-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 N LITCHFIELD RD",
            "address_2": "SUITE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957804",
            "telephone_number": "623-935-5505",
            "fax_number": "653-935-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MIGUEL",
        "middle_name": "R",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252713",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisol G Hercegovac
• Siomara Hercules, FNP
• Shannon Elise Herman, PT, DPT
• Adriana Hernandez Onofre, RBT
• Denise Hernandez, FNP-C
• Nicole Hernandez, OTR/L
• Ray Conrad Espiritu Hernandez
• Maricella Josephina-Juanita Herrera
• William J Herrmann, MD
• Mercedes Herzog

• Physical Therapist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.