Individual provider Active NPI

Angelique Hernandez

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1407749161
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP324040 Issued in AZ
Practice address
1401 N 24TH St Ste 100
Phoenix, AZ 85008-4645
Phone
(602) 844-7246
NPI assigned
Jun 2, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RNP324040 AZ Primary

Addresses

Primary practice location

1401 N 24TH St Ste 100
Phoenix, AZ 85008-4645

Mailing address

1401 N 24TH St Ste 100
Phoenix, AZ 85008-4645
Phone (602) 844-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250630003036 AZ Practitioner - Nurse Practitioner 4486167731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Z Pain LLCGroup PAC ID 2264842947, 3 clinicians

Practice addresses (Care Compare)

1401 N 24TH St
Suite 100
Phoenix, AZ 85008-4645
Phone (602) 844-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RNP324040AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Z Pain LLC CurrentSince May 22, 2025 Accepting new patients
Sonoran Rising Anesthesia LLC CurrentSince May 22, 2025 Accepting new patients

Locations

1401 N 24th St
Ste 100
Phoenix, AZ 85008
Phone (602) 844-7246

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": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1407749161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 24TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084645",
            "telephone_number": "602-844-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 24TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084645",
            "telephone_number": "602-844-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ANGELIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP324040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.