Pablo I Hernandez Itriago, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

219852 Issued in MA

Practice address

19 Tacoma St
Worcester, MA 01605-3516

Phone

(508) 852-1805

NPI assigned

Aug 10, 2006

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 12

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward M Kennedy Community Health Center IncGroup PAC ID 3476512740, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Milford Regional Medical Center Hospital, Milford, MA, CCN 220090
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Metrowest Medical Center Hospital, Framingham, MA, CCN 220175

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pablo.hernandez.p1@direct.emkchc.nextgenshare.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1316324650

  W-2 Managing Employee

  CMS ownership

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.

• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1609842152
  Medicare reassignment Care Compare group NPD
• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1316324650
  NPD
• Edward M. Kennedy Community Health Center, Inc

  • Clinic Pharmacy
  • Worcester, MA
  • NPI 1013048347
  NPD (past)
• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Milford, MA
  • NPI 1992137426
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Umass Memorial Health-Milford Regional Medical Center Inc

  • General Acute Care Hospital
  • Milford, MA
  • NPI 1477527497
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation
• VHS Acquisition Subsidiary Number 9 Inc

  • General Acute Care Hospital
  • Framingham, MA
  • NPI 1740252592
  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1457362931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 LINCOLN ST",
            "address_2": "DOB 503",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052060",
            "telephone_number": "508-532-7318",
            "fax_number": "508-852-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ ITRIAGO",
        "first_name": "PABLO",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "219852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMSP",
            "identifier": "70172",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON SELECT",
            "identifier": "90590",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110090943A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "97000901",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-GROUP",
            "identifier": "Y10141",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA16802",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J28324",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP-GROUP",
            "identifier": "0006767",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300709",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH-GROUP",
            "identifier": "042485308",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7674093",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0033107",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Here We Grow Baby LLC
• Diane L. Herlihy-Rayla, CNM
• Mary M. Herlihy, M.D.
• Christina R Hermos, M.D.
• Glinda Alexandra Hernandez Cuevas, PHARMD
• Yohel Hernandez Jimenez, M.D.
• Ashley Hernandez
• Brenda Hernandez
• Daniela Hernandez
• Isaac Hernandez, S.W.

• Family Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.