Active NPI
Patricia Hernandez, APRN
- Family Nurse Practitioner
- West Hartford, CT
National Provider Identifier
1902995855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 002763
- Practice address
- 1216 Farmington Ave
Suite 102
West Hartford, CT 06107-2672 - Phone
- (860) 561-1007
- Fax
- (860) 561-1222
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 002763 | CT | Primary |
Addresses
Primary practice location
1216 Farmington Ave
Suite 102
West Hartford, CT 06107-2672
Mailing address
1216 Farmington Ave
Suite 102
West Hartford, CT 06107-2672
Phone (860) 561-1007
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C03887 | Other | CT | MEDICARE GROUP |
| 008039644 | Medicaid | CT | |
| 500000218 | Other | CT | MEDICAID GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002763 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Roberto Medina, MD LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Wethersfield, CT
- NPI 1083798821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1902995855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 FARMINGTON AVE",
"address_2": "SUITE 102",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072672",
"telephone_number": "860-561-1007",
"fax_number": "860-561-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1216 FARMINGTON AVE",
"address_2": "SUITE 102",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072672",
"telephone_number": "860-561-1007",
"fax_number": "860-561-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "PATRICIA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "002763",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "C03887",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008039644",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "500000218",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.