Thomas R Hernandez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00033054 Issued in WA

Practice address

4801 Beckner Rd
Level 2 Pod 1 Ste 2600
Santa Fe, NM 87507-0000

Phone

(505) 772-2000

NPI assigned

Jan 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment NPD
• Sanford Health of Northern Minnesota

  dba Sanford Health Behavioral Health Administration Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bemidji, MN
  • NPI 1427567601
  NPD
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD
• Presbyterian Healthcare Services

  dba Presbyterian Santa Fe Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1730684853
  NPD (past)

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1568440428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 BECKNER RD",
            "address_2": "LEVEL 2 POD 1 STE 2600",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875070000",
            "telephone_number": "505-772-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2021-0914",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00033054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS NUMBER",
            "identifier": "8191884",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Hernandez
• Ivanna Hernandez
• Mariyah Hernandez
• Renee Hernandez, BMS AND CSW
• Sheryl Hernandez
• Yared E Hernandez, LMHC
• Hero Dental of Santa Fe PC (Adventure Dental, Vision and Orthodontics)
• Hero Vision of Santa Fe LLC (Adventure Dental, Vision and Orthodontics)
• Peter Herr, PH.D.
• Lauren Samantha Herrel

• Pediatrics Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.