Individual provider Active NPI

Edith Giuliana Hernandez Hinostroza, M.D.

  • Pediatrics Physician
  • Nogales, AZ
National Provider Identifier
1780936922
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
50137 Issued in AZ
Practice address
1852 N Mastick Way
Nogales, AZ 85621-1063
Phone
(520) 281-1550
Fax
(520) 281-1112
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 50137 AZ Primary

Addresses

Primary practice location

1852 N Mastick Way
Nogales, AZ 85621-1063

Mailing address

825 N Grand Ave Ste 100
Nogales, AZ 85621-1061
Phone (520) 281-1550

Other identifiers 1

IdentifierTypeStateIssuer
045529MedicaidAZ

Other names 1

  • Edith G Hernandez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150904000044 AZ Practitioner - Pediatric Medicine 8729394820 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50137AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc CurrentSince Sep 1, 2015 Accepting new patients
Mariposa Community Health Center, Inc Pediatrics Current Accepting new patients
Mariposa Community Health Center, Inc Pediatrics CurrentSince Sep 1, 2015 Accepting new patients
Mariposa Community Health Center, Inc Pediatrics Current Accepting new patients
Mariposa Community Health Center, Inc Pediatrics Past Accepting new patients
HCH Tucson Holdings LLC Past Accepting new patients

Locations

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1852 N Mastick Way
Nogales, AZ 85621

507 N Western Ave
Nogales, AZ 85621
Phone (520) 229-0085

1835 N Mastick Way
Nogales, AZ 85621
Phone 5202811550 ext. 1180

1103 Circulo Mercado
Rio Rico, AZ 85648
Phone 5202811550 ext. 1180

Interoperability endpoints

  • Direct secure messaging: edithg.hernandez.p1@direct.azch.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1780936922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-281-1550",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-281-1550",
            "fax_number": "520-281-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ HINOSTROZA",
        "first_name": "EDITH",
        "middle_name": "GIULIANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045529",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDITH",
            "last_name": "HERNANDEZ",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nogales, AZ

Sources for this page

Verify at the official NPI Registry.