Individual provider Active NPI

Luis Fernando Hernandez, PA-C

  • Physician Assistant
  • Alamosa, CO
National Provider Identifier
1487088852
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0003766 Issued in CO
Practice address
128 Market St
Alamosa, CO 81101-2290
Phone
(719) 589-5161
NPI assigned
Aug 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0003766 CO Primary

Addresses

Primary practice location

128 Market St
Alamosa, CO 81101-2290

Mailing address

211 Edison Ave
Alamosa, CO 81101-2531
Phone (208) 316-6272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20140516000107 CO Practitioner - Physician Assistant 9931322187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley-Wide Health Systems, Inc.Group PAC ID 5991609067, 42 clinicians

Practice addresses (Care Compare)

1012 Belmont Ave
La Junta, CO 81050-2101
Phone (719) 383-5900

925 2ND Ave
Monte Vista, CO 81144-1432
Phone (719) 587-1001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0003766COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley-Wide Health Systems, Inc. CurrentSince Feb 16, 2014 Accepting new patients
Valley-Wide Health Systems, Inc CurrentSince Feb 16, 2014 Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients

Locations

128 Market St
Alamosa, CO 81101
Phone (719) 587-1001

1131 Main St
Alamosa, CO 81101
Phone (719) 589-2562

186 Hurt St
Center, CO 81125
Phone (719) 754-2778

1012 Belmont Ave
La Junta, CO 81050
Phone (719) 383-5500

Interoperability endpoints

  • Direct secure messaging: luis.hernandez.p1@direct.vwhs.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1487088852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EDISON AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012531",
            "telephone_number": "208-316-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MARKET ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012290",
            "telephone_number": "719-589-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0003766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.