Individual provider Active NPI

Elba Fernandez, ARNP

  • Nurse Practitioner
  • Sunnyside, WA
National Provider Identifier
1780132704
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60698647 Issued in WA
Practice address
700 S 11TH St
Sunnyside, WA 98944-2243
Phone
(509) 839-6822
Fax
(509) 839-5913
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60698647 WA Primary

Addresses

Primary practice location

700 S 11TH St
Sunnyside, WA 98944-2243

Mailing address

PO Box 957
Sunnyside, WA 98944-0957
Phone (509) 839-6822

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216001601 WA Practitioner - Nurse Practitioner 4385924927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Valley Community Clinic PLLCGroup PAC ID 8729976998, 7 clinicians

Practice addresses (Care Compare)

700 S 11TH St
Sunnyside, WA 98944-2243
Phone (509) 839-6822

Hospital & facility affiliations

  • Astria Sunnyside Hospital Hospital, Sunnyside, WA, CCN 501330
  • Prosser Memorial Hospital Hospital, Prosser, WA, CCN 501312

Merit-based Incentive Payment System (MIPS)

Final score
83.73 of 100Reported as group
Quality
80.23
Promoting interoperability
82
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60698647WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Emergency Group a Professional LLC Nurse Practitioner CurrentSince Sep 27, 2017 Accepting new patients
Mid-Valley Community Clinic, PLLC CurrentSince Dec 1, 2016 Accepting new patients

Locations

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

700 S 11th St
Sunnyside, WA 98944
Phone (509) 839-6288

Organizations & group practices 2

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 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": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1780132704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989440957",
            "telephone_number": "509-839-6822",
            "fax_number": "509-839-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S 11TH ST",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442243",
            "telephone_number": "509-839-6822",
            "fax_number": "509-839-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ELBA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60698647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

Verify at the official NPI Registry.