Individual provider Active NPI

Wilfred Irving Hernandez, MD

  • Internal Medicine Physician
  • Arecibo, PR
National Provider Identifier
1376896035
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19539 Issued in PR
Practice address
Galeria Pacifico Carr. 10 KM 85.7 Suite 5
Arecibo, PR 00613
Phone
(787) 878-7564
Fax
(787) 878-7218
NPI assigned
Oct 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19539 PR Primary

Addresses

Primary practice location

Galeria Pacifico Carr. 10 KM 85.7 Suite 5
Arecibo, PR 00613

Mailing address

Laurel Ave 100
Urb. Santa Juanita
Bayamon, PR 00956
Phone (787) 787-5151

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
I20170418001379 PR Practitioner - Internal Medicine 3870879364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Gastro-Centro Norte PSCGroup PAC ID 7618199688, 3 clinicians

Practice addresses (Care Compare)

Galeria Pacifico Carr 10 KM 85
Arecibo, PR 00613
Phone (787) 878-7564

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19539PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro-Centro Norte PSC CurrentSince Feb 11, 2017 Accepting new patients

Organizations & group practices 1

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1376896035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAUREL AVE 100",
            "address_2": "URB. SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-787-5151",
            "fax_number": "787-269-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GALERIA PACIFICO CARR. 10 KM 85.7 SUITE 5",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00613",
            "telephone_number": "787-878-7564",
            "fax_number": "787-878-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "WILFRED",
        "middle_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.