Individual provider Active NPI

Celestine Q Hernandez, MD

  • Pediatrics Physician
  • Elko, NV
National Provider Identifier
1689739161
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8882 Issued in NV
Practice address
1995 Errecart Blvd Ste 103
Elko, NV 89801-8336
Phone
(775) 738-3111
Fax
(775) 778-6728
NPI assigned
Dec 26, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8882 NV Primary

Addresses

Primary practice location

1995 Errecart Blvd Ste 103
Elko, NV 89801-8336

Mailing address

1995 Errecart Blvd Ste 103
Elko, NV 89801-8336
Phone (775) 738-3111

Other identifiers 3

IdentifierTypeStateIssuer
8882OtherNVSTATE LICENSE
002004121MedicaidNV
CS09275OtherNVSTATE PHARMACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503003285 NV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9830147701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8882NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Home Health Services, Inc. PastSince Apr 30, 2003 Accepting new patients
Hogle Miller & Ward Professional Corporation Past Accepting new patients
Genesis Hospice, LLC PastSince Mar 30, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/mi-elko

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Genesis Home Health Services, Inc.Elko, NV, CCN 297125 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Genesis Home Health Services, Inc.Winnemucca, NV, CCN 297300 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
W-2 Managing Employee (100%)
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Genesis Home Health Services, Inc.Ely, NV, CCN 297205 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)
Operational/Managerial Control (50%)
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Jun 14, 2004
Genesis Hospice, LLCElko, NV, CCN 291555 Hospice 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)
Operational/Managerial Control (50%)
Mar 17, 2016
Mar 17, 2016
Mar 17, 2016
Mar 30, 2017
Mar 30, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689739161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD STE 103",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018336",
            "telephone_number": "775-738-3111",
            "fax_number": "775-778-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD STE 103",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018336",
            "telephone_number": "775-738-3111",
            "fax_number": "775-778-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "CELESTINE",
        "middle_name": "Q",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "8882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8882",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002004121",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY",
            "identifier": "CS09275",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

Verify at the official NPI Registry.