Carlos E Hernandez Moreno, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

7536 Issued in PR

Practice address

14 Great Plains Road
Arapahoe, WY 82510-0014

Phone

(307) 856-9281

Fax

(307) 463-4489

NPI assigned

Aug 10, 2006

Last updated

Aug 10, 2020By the provider in NPPES

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

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wind River Family & Community Healthc Care

  • Federal Public Health Clinic/Center
  • Arapahoe, WY
  • NPI 1285006379

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1386655058",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "PO BOX 1310",
            "address_2": "PO BOX 1310",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "82501",
            "telephone_number": "787-895-0045",
            "fax_number": "787-817-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GREAT PLAINS ROAD",
            "city": "ARAPAHOE",
            "state": "WY",
            "postal_code": "825100014",
            "telephone_number": "307-856-9281",
            "fax_number": "307-463-4489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CARR #2 KM 102.2",
            "address_purpose": "LOCATION",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "country_code": "US",
            "telephone_number": "787-598-6114",
            "fax_number": "787-817-2571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ MORENO",
        "first_name": "CARLOS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "7536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T-SSS",
            "identifier": "29594",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Arapahoe",
            "affiliation": "N",
            "endpointDescription": "clinic",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Arapahoe",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14 Great Plains Road",
            "city": "Arapahoe",
            "state": "WY",
            "country_code": "US",
            "postal_code": "825100014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffini Hackett, BSW
• Mary Frances Hailey
• Jordan Justice Harbaugh-Williams, MD
• Tamara M Harris Myers
• Emma Bianca Hatch, MSW, PCSW
• Paige Laurel Huntsman, CAPA064
• Evelyn Jimenez
• K-N CMS
• Mary Pauline Killsontop
• Nancy Lee King, FNP

• Pediatrics Physician in Arapahoe, WY
• Providers in Arapahoe, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.