Individual provider Active NPI

Gisselle Refugio Hernandez, OD

  • Optometrist
  • Surprise, AZ
National Provider Identifier
1518899731
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002939 Issued in AZ
Practice address
13641 N Prasada Pkwy
Surprise, AZ 85388-8011
Phone
(623) 401-1275
Fax
(623) 440-2116
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002939 AZ Primary

Addresses

Primary practice location

13641 N Prasada Pkwy
Surprise, AZ 85388-8011

Mailing address

13641 N Prasada Pkwy
Surprise, AZ 85388-8011
Phone (623) 401-1275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260617003578 AZ Practitioner - Optometry 3678045952

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13007 W Krall CT
Glendale, AZ 85307-4509

19100 Ridgewood Pkwy
San Antonio, TX 78259-1828

19100 Ridgewood Pkwy
BLDG 1 7TH Floor
San Antonio, TX 78259-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002939AZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1518899731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13641 N PRASADA PKWY",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853888011",
            "telephone_number": "623-401-1275",
            "fax_number": "623-440-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13641 N PRASADA PKWY",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853888011",
            "telephone_number": "623-401-1275",
            "fax_number": "623-440-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GISSELLE",
        "middle_name": "REFUGIO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.