Individual provider Active NPI

Amy Marie Hernandez, PA-C, MS

  • Medical Physician Assistant
  • Salem, OR
National Provider Identifier
1609279298
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA169940 Issued in OR
Practice address
3025 Ryan Dr SE
Salem, OR 97301-5057
Phone
(503) 540-9999
Fax
(503) 540-3105
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA169940 OR Primary

Addresses

Primary practice location

3025 Ryan Dr SE
Salem, OR 97301-5057

Mailing address

875 Oak St SE Ste 4030
Salem, OR 97301-3984
Phone (503) 561-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150401000868 OR Practitioner - Physician Assistant 8820315807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Salem Family Practice Associates LLCGroup PAC ID 7113911504, 6 clinicians
Oregon Oncology Specialists LLPGroup PAC ID 3971576240, 41 clinicians

Practice addresses (Care Compare)

1275 Wallace Rd NW
Salem, OR 97304-3007
Phone (503) 371-3232

3025 Ryan Dr SE
Salem, OR 97301-5057
Phone (503) 485-0350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA169940ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Oncology Specialists, LLP CurrentSince Dec 27, 2021 Accepting new patients

Locations

875 Oak St SE
Ste 4030
Salem, OR 97301

3025 Ryan Dr SE
Salem, OR 97301
Phone (503) 485-0350

2720 Commercial St SE
Ste 201
Salem, OR 97302
Phone (503) 480-0485

Interoperability endpoints

  • Direct secure messaging: amy.hernandez@hoos.ikm.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1609279298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 4030",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013984",
            "telephone_number": "503-561-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015057",
            "telephone_number": "503-540-9999",
            "fax_number": "503-540-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA169940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.