NPIMap

Individual provider Active NPI

Juan Manuel Herrera-Godinez, P.A.

  • Medical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1528383627
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MED-PAC-LIC-97431 Issued in MT
Practice address
Medical Center Blvd
Winston Salem, NC 27157
Phone
(336) 716-2255
NPI assigned
Mar 31, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08059 NC
Physician Assistant 363A00000X PA22391 CA
Physician Assistant 363A00000X PA156586 OR
Medical Physician Assistant 363AM0700X MED-PAC-LIC-97431 MT Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other practice location 1

655 Euclid Ave Ste 304
National City, CA 91950-2974
Phone (619) 470-7700

Other identifiers 1

IdentifierTypeStateIssuer
W18505OtherCAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181231001902 NC Practitioner - Physician Assistant 0941450159 Reassigns benefits to 1 organization
I20210924000284 MT Practitioner - Physician Assistant 0941450159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2675 Central Ave
Billings, MT 59102-6686
Phone (406) 238-2500

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

760 Wicks Lane
Billings, MT 59105-4427
Phone (406) 238-2501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA156586ORMDPhysician Assistant
MED-PAC-LIC-97431MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Jun 17, 2019 Accepting new patients
Cornerstone Health Care PA CurrentSince Jun 17, 2019 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Oct 11, 2021 Accepting new patients
Billings Clinic Physician Assistant CurrentSince Oct 11, 2021 Accepting new patients
Peak Health and Wellness, PLLC Past Accepting new patients
Caring Hearts Medical Foundation and Health Services Inc Past Accepting new patients

Locations

760 Wicks Ln
Billings, MT 59105
Phone (406) 238-2475

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: jherreragodinez1@billingsclinic.cernerdirect.com

Organizations & group practices 10

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 8

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1528383627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Euclid Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502974",
            "country_code": "US",
            "telephone_number": "619-470-7700",
            "fax_number": "619-470-0996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA-GODINEZ",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-31",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08059",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22391",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA156586",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MED-PAC-LIC-97431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W18505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.