Individual provider Active NPI

Iridiana Hermenegildo

  • Physician Assistant
  • Hanford, CA
National Provider Identifier
1801501861
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62281 Issued in CA
Practice address
115 Mall Dr
Hanford, CA 93230-5786
Phone
(559) 582-9000
NPI assigned
Jan 13, 2023
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA62281 CA Primary
Medical Physician Assistant 363AM0700X CA

Addresses

Primary practice location

115 Mall Dr
Hanford, CA 93230-5786

Mailing address

507 S Laguna St
Visalia, CA 93292-3680
Phone (209) 676-1807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230306000900 CA Practitioner - Physician Assistant 2567835929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA62281CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Mar 1, 2023 Accepting new patients
Cep America-California CurrentSince Mar 1, 2023 Accepting new patients
Cep America - California CurrentSince Mar 1, 2023 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1801501861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S LAGUNA ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923680",
            "telephone_number": "209-676-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MALL DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305786",
            "telephone_number": "559-582-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMENEGILDO",
        "first_name": "IRIDIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62281",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.