Juan Jose Hernandez, PA-C, MS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13448852-1206 Issued in UT

Practice address

5171 S Cottonwood St Ste 910
Salt Lake City, UT 84107-5759

Phone

(801) 507-9950

Fax

(801) 507-1492

NPI assigned

Jun 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physician Assistant

Education

Rutgers New Jersey Medical School, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services Inc 3,948 clinicians

Revere Health PC 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juanhernandez@cuccu.allscriptsdirect.net

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.

• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805

  UT

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154

  UT

  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  UT

  Medicare reassignment
• Revere Health PC

  • Orthopaedic Surgery Physician
  • Saratoga Springs, UT
  • NPI 1538867999
  Care Compare group
• Revere Health PC

  • Orthopaedic Surgery Physician
  • Orem, UT
  • NPI 1780017954
  Care Compare group
• Revere Health PC

  • Orthopaedic Surgery Physician
  • American Fork, UT
  • NPI 1891813960
  Care Compare group
• Revere Health PC

  • Pharmacist
  • Provo, UT
  • NPI 1922156884
  Care Compare group
• Ihc Health Services Inc

  • Orthopaedic Surgery Physician
  • Highland, UT
  • NPI 1740515964
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)
• Ihc Health Services Inc

  • Neurology Physician
  • Murray, UT
  • NPI 1831476308
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1689358186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-507-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 910",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075759",
            "telephone_number": "801-507-9950",
            "fax_number": "801-507-1492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N 500 W Ste 121",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-373-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "credential": "PA-C, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13448852-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claudia G Hernandez
• Delia Nayeli Hernandez
• Esteban Hernandez
• Issa Fernanda Hernandez I
• Joe Isaac Wade Hernandez
• June Lee Hernandez
• Karah Hernandez
• Linda Hernandez
• Maikel Hernandez
• Maria Cristina Hernandez

• All providers in Salt Lake City, UT
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.
• 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.