Individual provider Active NPI

Ambrosio Hernandez III, M.D.

  • Pediatric Surgery Physician
  • McAllen, TX
National Provider Identifier
1801845318
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
L9980 Issued in TX
Practice address
1120 E Ridge Rd
McAllen, TX 78503-5411
Phone
(956) 688-1280
Fax
(956) 688-1291
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X L9980 TX Primary

Addresses

Primary practice location

1120 E Ridge Rd
McAllen, TX 78503-5411

Mailing address

1120 E Ridge Rd
McAllen, TX 78503-5411
Phone (956) 688-1280

Other identifiers 3

IdentifierTypeStateIssuer
172230802OtherTXCSHCN
172230801MedicaidTX
8P5610OtherTXBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041228000344 TX Practitioner - Pediatric Medicine 6204894942 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9980TXMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Medical Foundation PastSince Jun 30, 2014 Accepting new patients
Therapy R US Rehabilitation Specialists PLLC PastSince Dec 15, 2009 Accepting new patients
Driscoll Childrens Hospital Past Accepting new patients
Doctors Hospital at Renaissance, LTD Past Accepting new patients
Renaissance Hospitalists PastSince Mar 29, 2014 Accepting new patients
Children'S Physician Services of South Texas PastSince May 1, 2017 Accepting new patients
Palm Valley Pediatric Surgeons PLLC PastSince Feb 1, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3fe59471-3589-4f65-b447-b92822bfc057/

Organizations & group practices 8

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1801845318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E RIDGE RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785035411",
            "telephone_number": "956-688-1280",
            "fax_number": "956-688-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E RIDGE RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785035411",
            "telephone_number": "956-688-1280",
            "fax_number": "956-688-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "AMBROSIO",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "L9980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "172230802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172230801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8P5610",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.