Individual provider Active NPI

Jorge Luis Reguero Hernandez, M.D.

  • Colon & Rectal Surgery Physician
  • Saginaw, MI
National Provider Identifier
1700029394
Registry record updated Jul 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
4301116413 Issued in MI
Practice address
5415 Cardinal Square Blvd
Saginaw, MI 48604-8200
Phone
(989) 790-4855
NPI assigned
Apr 12, 2009
Last updated
Jul 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 4301116413 MI Primary

Addresses

Primary practice location

5415 Cardinal Square Blvd
Saginaw, MI 48604-8200

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181012002742 MI Practitioner - Colorectal Surgery (Proctology) 1759601214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

5415 Cardinal Square Blvd
Saginaw, MI 48604-8200
Phone (989) 790-4855

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301116413MIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince Oct 3, 2018 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Covenant Medical Center, Inc. Past Accepting new patients

Locations

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

5415 Cardinal Square Blvd
Saginaw, MI 48604
Phone (989) 583-5679

Interoperability endpoints

  • Direct secure messaging: jreguerohernandez73580@direct.covenanthealthcare.com

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.

Hospital & facility affiliations 2

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": "1239494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1700029394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 CARDINAL SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486048200",
            "telephone_number": "989-790-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGUERO HERNANDEZ",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-12",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "4301116413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.