Individual provider Active NPI

Erica Hernandez, PA-C

  • Physician Assistant
  • Grapevine, TX
National Provider Identifier
1518737253
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17586 Issued in TX
Practice address
1631 Lancaster Dr Ste 330
Grapevine, TX 76051-3586
Phone
(817) 953-3420
Fax
(817) 953-3418
NPI assigned
Jan 4, 2024
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 PA17586 TX Primary

Addresses

Primary practice location

1631 Lancaster Dr Ste 330
Grapevine, TX 76051-3586

Mailing address

9330 Lyndon B Johnson Fwy Ste 800
Dallas, TX 75243-4310
Phone (972) 792-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240223001852 TX Practitioner - Physician Assistant 1052756541 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John Kevin Page, MD PLLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

1631 Lancaster Dr
Ste 330
Grapevine, TX 76051
Phone (817) 953-3420

Interoperability endpoints

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1518737253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 LYNDON B JOHNSON FWY STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434310",
            "telephone_number": "972-792-5700",
            "fax_number": "817-953-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 LANCASTER DR STE 330",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513586",
            "telephone_number": "817-953-3420",
            "fax_number": "817-953-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ERICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.