Individual provider Active NPI

Gerardo Hurtado, PA-C

  • Physician Assistant
  • Gary, IN
National Provider Identifier
1497075261
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001146A Issued in IN
Practice address
600 Grant St
Gary, IN 46402-6001
Phone
(219) 886-4405
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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 10001146A IN Primary

Addresses

Primary practice location

600 Grant St
Gary, IN 46402-6001

Mailing address

2692 Teresa St
Portage, IN 46368-3642
Phone (219) 331-3264

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001146AINMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1497075261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2692 TERESA ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683642",
            "telephone_number": "219-331-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026001",
            "telephone_number": "219-886-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "GERARDO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001146A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.