Individual provider Active NPI

Teresa Anaya Hernandez, MD

  • Developmental - Behavioral Pediatrics Physician
  • Ft Lauderdale, FL
National Provider Identifier
1518970110
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME75076 Issued in FL
Practice address
1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737
Phone
(954) 351-5840
Fax
(954) 351-7725
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X ME75076 FL Primary

Addresses

Primary practice location

1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737

Mailing address

1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737
Phone (954) 351-5840

Other identifiers 1

IdentifierTypeStateIssuer
257307500MedicaidFL

Other names 1

  • Mrs. Teresa Anaya Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address teresa.hernandez001@holy-cross.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000470 FL Practitioner - Pediatric Medicine 4284814120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Nov 1, 2022 Accepting new patients
Holy Cross Hospital Inc CurrentSince Nov 1, 2022 Accepting new patients
Variety Children'S Hopsital Past Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

1900 E Commercial Blvd
Ste 202
Ft Lauderdale, FL 33308
Phone (954) 351-5840

Interoperability endpoints

  • Direct secure messaging: tanayahernandez2061136@direct.trinity-health.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1518970110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083737",
            "telephone_number": "954-351-5840",
            "fax_number": "954-351-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083737",
            "telephone_number": "954-351-5840",
            "fax_number": "954-351-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "TERESA",
        "middle_name": "ANAYA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME75076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257307500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teresa.hernandez001@holy-cross.com",
            "affiliation": "N",
            "endpointDescription": "Holy Cross Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1900 E Commercial Blvd",
            "address_2": "Suite 202",
            "city": "Ft Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333083737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ANAYA",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.