Eivy Tatiana Herrera, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12864 Issued in TX

Practice address

6124 W Parker Rd Ste 530
Plano, TX 75093-8140

Phone

(469) 916-0087

NPI assigned

Jul 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Assistant Services of Texas L.L.PGroup PAC ID 2062303803, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
• Texas Health Heart & Vascular Hospital Arlington Hospital, Arlington, TX, CCN 670071

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eivy.herrera.p1@direct.swpulmonary.nextgenshare.com
• Direct secure messaging: eherrera166975@direct.texashealth.org

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.

• Physician Assistant Services of Texas L.L.P

  • Medical Physician Assistant
  • Fort Worth, TX
  • NPI 1164467692
  Medicare reassignment Care Compare group NPD
• TMH Physician Associates PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1275779225
  Medicare reassignment NPD
• Cogent Healthcare of Texas, PA

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1992722953
  Medicare reassignment
• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment
• TMH Physician Associates PLLC

  • Orthopaedic Surgery Physician
  • Spring, TX
  • NPI 1043061351
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amh Cath Labs LLC

  • Special Hospital
  • Arlington, TX
  • NPI 1407169196
  Care Compare affiliation
• Baylor All Saints Medical Center

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1669472387
  Care Compare affiliation
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1831741271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9024 SAGEWOOD DR APT 9101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761772285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 W PARKER RD STE 530",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938140",
            "telephone_number": "469-916-0087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 Keller Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762482486",
            "country_code": "US",
            "telephone_number": "682-593-4273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "EIVY",
        "middle_name": "TATIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA12864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA12864",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "firstkellerhealth@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "891 Keller Pkwy Ste 101",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762482486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elinda M Hernandez, RN-FNP
• Lavonne Hernandez, LPC
• Megan Hernandez, PT
• Justine Herr-Cardoza
• Destinie M Herrera
• Madison Dunn Herrera, CD
• Mark Edward Herrera, M.D.
• Kerri Herrington
• Deanna Herrmann
• Richard F Herrscher, MD

• Medical Physician Assistant in Plano, TX
• Providers in Plano, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.