Raul P Ibanez Hernandez Sr., APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG02250080 Issued in KY

Practice address

3828 Bardstown Rd
Louisville, KY 40218-1527

Phone

(502) 479-8930

NPI assigned

Feb 25, 2025

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

Medicare fee-for-service enrollment

Enrolled in KY

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Duvalle Community Health Center, IncGroup PAC ID 1658268974, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raul.ibanez-hernandez.1@27238.direct.athenahealth.com

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.

• Park Duvalle Community Health Center, Inc.

  dba Russell Neighborood Health Center

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1255354361
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY

  Medicare reassignment NPD
• Park Duvalle Community Health Center, Inc

  dba Park DuValle at West End School

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1497625263
  NPD
• Park Duvalle Community Health Center, Inc

  dba Park Duvalle at Central Health Center

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1639727951
  NPD
• Park Duvalle Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1245253160
  NPD

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1699571083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 EL PATIO PL APT 214",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402206005",
            "telephone_number": "502-544-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181527",
            "telephone_number": "502-479-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ HERNANDEZ",
        "first_name": "RAUL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "AG02250080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Marie Hynes
• Taylor Hysell
• I Management LLC
• David Ianke, L.C.S.W.
• Paulette Iannone
• Onyinyechukwu Ibekwe
• Emily Conrad Ibershoff, LPCC MT-BC
• Aimen Ismail Ibrahim, PHARMD
• Essam Abdelrahman Adam Ibrahim, DPT
• Kirolos Ibrahim Mikhael Ibrahim, MD

• Gerontology Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Gerontology Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.