Individual provider Active NPI

Stephen Michael Fernandez, M.D.

  • Anesthesiology Physician
  • Arcadia, CA
National Provider Identifier
1427064070
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G48005 Issued in CA
Practice address
614 W Duarte Rd
Arcadia, CA 91007-7601
Phone
(626) 445-4714
Fax
(626) 445-1701
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G48005 CA Primary

Addresses

Primary practice location

614 W Duarte Rd
Arcadia, CA 91007-7601

Mailing address

225 S Lake Ave
535
Pasadena, CA 91101-3005
Phone (626) 795-6596

Other identifiers 3

IdentifierTypeStateIssuer
00G480051OtherCABLUE SHIELD
00G480051MedicaidCA
00G480050MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080404000424 CA Practitioner - Anesthesiology 4981781663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Francisco School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 W Duarte Rd
Arcadia, CA 91007-7601
Phone (626) 445-4714

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G48005CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen M Fernandez M D Inc a Professional Corporation Anesthesiology CurrentSince Jul 24, 1998 Accepting new patients

Locations

614 W Duarte Rd
Arcadia, CA 91007
Phone (626) 445-4714

225 S Lake Ave
Ste 535
Pasadena, CA 91101

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1427064070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S LAKE AVE",
            "address_2": "535",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013005",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W DUARTE RD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077601",
            "telephone_number": "626-445-4714",
            "fax_number": "626-445-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G48005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G480051",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G480051",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G480050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.