Individual provider Active NPI

Michael Austin Hernandez

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1609605666
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3052 NW Merchant Way Ste 100
Bend, OR 97703-5466
Phone
(541) 797-5800
Fax
(541) 249-5103
NPI assigned
Jul 29, 2024
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3052 NW Merchant Way Ste 100
Bend, OR 97703-5466

Mailing address

3052 NW Merchant Way Ste 100
Bend, OR 97703-5466
Phone (541) 797-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909001905 OR Practitioner - Physical Therapist in Private Practice 0244770907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiofitness Solutions LLCGroup PAC ID 5890181648, 5 clinicians

Practice addresses (Care Compare)

1334 NE 2ND St
Bend, OR 97701-4344
Phone (781) 674-6129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiofitness Solutions, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Prentice Chiropractic LLC PastSince Aug 4, 2024 Accepting new patients

Locations

1334 NE 2nd St
Bend, OR 97701
Phone (541) 797-5800

3052 NW Merchant Way
Ste 100
Bend, OR 97703
Phone (541) 797-5800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1609605666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3052 NW MERCHANT WAY STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035466",
            "telephone_number": "541-797-5800",
            "fax_number": "541-249-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3052 NW MERCHANT WAY STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035466",
            "telephone_number": "541-797-5800",
            "fax_number": "541-249-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MICHAEL",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.