Individual provider Active NPI

Rafael Arnoldo Fernandez, MD

  • Internal Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1831484500
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50596 Issued in AZ
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 214-2920
Fax
(928) 214-2925
NPI assigned
Jun 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50596 AZ Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 773-2559

Other identifiers 1

IdentifierTypeStateIssuer
044319MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150902003362 AZ Practitioner - HospitalistPractitioner - Internal Medicine 5092021204 Reassigns benefits to 1 organization
I20160816000359 TX Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5092021204 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pathology Associates Current Accepting new patients
Northern Arizona Healthcare Corporation Internal Medicine CurrentSince Nov 27, 2018 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 14, 2016 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Nov 27, 2018 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 14, 2016 Accepting new patients

Locations

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

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.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1831484500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-773-2559",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-214-2920",
            "fax_number": "928-214-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RAFAEL",
        "middle_name": "ARNOLDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "50596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044319",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.