Individual provider Active NPI

Roland Abel Hernandez, MD, JD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Seattle, WA
National Provider Identifier
1720213580
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD60854065 Issued in WA
Practice address
1600 E Jefferson St Ste 110
Seattle, WA 98122-5643
Phone
(206) 320-7300
Fax
(206) 320-4698
NPI assigned
May 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 257542 MA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD60854065 WA Primary

Addresses

Primary practice location

1600 E Jefferson St Ste 110
Seattle, WA 98122-5643

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

Other practice location 2

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Other identifiers 1

IdentifierTypeStateIssuer
1720213580MedicaidWA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rhernandez1041891@wm.providencedirect.org Direct
Direct Messaging Address rhernandez1041891@wm.providencedirect.org Direct
Direct Messaging Address rhernandez1041891@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20181011002419 WA Practitioner - Thoracic Surgery 1456603885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Michigan Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1600 E Jefferson St
Suite 110
Seattle, WA 98122-5643
Phone (206) 320-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257542MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 1, 2021 Accepting new patients
Swedish Health Services Surgery CurrentSince Sep 1, 2018 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 1, 2021 Accepting new patients
Swedish Health Services Surgery Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1600 E Jefferson St
Ste 110
Seattle, WA 98122
Phone (206) 320-7300

800 5th Ave
Ste 600
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: rhernandez1041891@wm.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1720213580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225643",
            "telephone_number": "206-320-7300",
            "fax_number": "206-320-4698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011665",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "fax_number": "425-339-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "747 Broadway",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-386-6000",
            "fax_number": "206-320-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ROLAND",
        "middle_name": "ABEL",
        "name_prefix": "Dr.",
        "credential": "MD, JD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-22",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "257542",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD60854065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720213580",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhernandez1041891@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "747 Broadway",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981224379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhernandez1041891@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1600 E Jefferson St Ste 110",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhernandez1041891@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1321 Colby Ave",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.