Individual provider Active NPI

Raymond Joseph Fernandez, PA-C

  • Physician Assistant
  • Powell, TN
National Provider Identifier
1619635596
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7714 Conner Rd Ste 103
Powell, TN 37849-3559
Phone
(659) 388-1218
Fax
(865) 212-5561
NPI assigned
Dec 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7714 Conner Rd Ste 103
Powell, TN 37849-3559

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220221000955 TN Practitioner - Physician Assistant 1951795749 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Surgical Associates PLLCGroup PAC ID 1254224181, 61 clinicians

Practice addresses (Care Compare)

7565 Dannaher Way
Powell, TN 37849-4029
Phone (865) 938-8121

9430 Parkwest Blvd
Suite 310
Knoxville, TN 37923-4203
Phone (865) 690-5263

Hospital & facility affiliations

  • Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
64.09
Promoting interoperability
98
Improvement activities
40
Cost
77.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4865TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc CurrentSince Feb 1, 2022 Accepting new patients
University Health System Inc CurrentSince Feb 1, 2022 Accepting new patients
Premier Surgical Associates, PLLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

6408 Papermill Dr
Ste 220
Knoxville, TN 37919
Phone (865) 306-5675

9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413

7714 Conner Rd
Ste 103
Powell, TN 37849
Phone (865) 938-6725

1130 Middle Creek Rd
Ste 260
Sevierville, TN 37862
Phone (865) 428-7586

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

Organizations & group practices 5

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 1

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1619635596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5700",
            "fax_number": "865-584-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7714 CONNER RD STE 103",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493559",
            "telephone_number": "659-388-1218",
            "fax_number": "865-212-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RAYMOND",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-07",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, TN

Sources for this page

Verify at the official NPI Registry.