NPIMap

Individual provider Active NPI

Susan Rizal Fernandez, MD

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1477669885
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9740 Issued in NV
Practice address
2621 W Horizon Ridge Pkwy
#100
Henderson, NV 89052-2895
Phone
(702) 263-1908
Fax
(702) 263-0195
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9740 NV Primary

Addresses

Primary practice location

2621 W Horizon Ridge Pkwy
#100
Henderson, NV 89052-2895

Mailing address

2621 W Horizon Ridge Pkwy
#100
Henderson, NV 89052-2895
Phone (702) 263-1908

Other identifiers 1

IdentifierTypeStateIssuer
003102477MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9740NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susan R Fernandez PC Pediatrics Past Accepting new patients
Dignity Health Past Accepting new patients
St Lukes - St Vincents Healthcare Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDHGAA/Endpoint/GDHGAA

Organizations & group practices 4

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1477669885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 W HORIZON RIDGE PKWY",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522895",
            "telephone_number": "702-263-1908",
            "fax_number": "702-263-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 W HORIZON RIDGE PKWY",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522895",
            "telephone_number": "702-263-1908",
            "fax_number": "702-263-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "SUSAN",
        "middle_name": "RIZAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003102477",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.