Individual provider Active NPI

Virgil Theodore Hernandez, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Santa Ana, CA
National Provider Identifier
1659395598
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3884 Issued in CA
Practice address
801 N Tustin Ave
Suite #202
Santa Ana, CA 92705-3612
Phone
(714) 265-5824
Fax
(714) 384-3897
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E3884 CA Primary

Addresses

Primary practice location

801 N Tustin Ave
Suite #202
Santa Ana, CA 92705-3612

Mailing address

22851 Maiden LN
Mission Viejo, CA 92692-4747
Phone (714) 265-5824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617001641 CA Practitioner - Podiatry 2961486600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Ana Tustin Podiatry Corporation Foot & Ankle Surgery CurrentSince Aug 7, 2012 Accepting new patients

Locations

661 W 1st St
Ste D
Tustin, CA 92780
Phone (714) 265-5824

13362 Newport Ave
Ste A
Tustin, CA 92780
Phone (714) 265-5824

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1659395598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22851 MAIDEN LN",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926924747",
            "telephone_number": "714-265-5824",
            "fax_number": "714-384-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N TUSTIN AVE",
            "address_2": "SUITE #202",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053612",
            "telephone_number": "714-265-5824",
            "fax_number": "714-384-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "VIRGIL",
        "middle_name": "THEODORE",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.