Emil Fernando, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2017001080 Issued in MO

Practice address

3100 Oak Grove Rd
Poplar Bluff, MO 63901

Phone

(573) 785-7721

NPI assigned

Jul 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Internal Medicine

Education

University of Missouri, Kansas City, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians

Generation Clinical Partners LLCGroup PAC ID 1557687803, shared by 2 NPIs, 24 clinicians

Pai Participant 27, PCGroup PAC ID 2668872672, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evertrue Hospice Hospice, Brentwood, MO, CCN 261631
• Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• Accolade Healthcare of Waterloo Nursing home, Waterloo, IL, CCN 145445
• Meridian Village Care Center Nursing home, Glen Carbon, IL, CCN 146142
• Mason Pointe Care Center Nursing home, Chesterfield, MO, CCN 265071

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emil.fernando.1@9850.direct.athenahealth.com
• Direct secure messaging: emilfernando@ihadv.allscriptsdirect.net
• FHIR API: https://api.platform.athenahealth.com/9850/brand/1/csg/1/fhir/r4

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.

• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  MO

  Medicare reassignment Care Compare group NPD
• Pai Participant 27, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Willowbrook, IL
  • NPI 1093398539
  Medicare reassignment Care Compare group NPD
• Butler Physician Services, LLC

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1982056545
  Medicare reassignment NPD
• CJW Enterprises, Inc.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1477876423
  Medicare reassignment NPD
• Generation Clinical Partners LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1104235241
  Medicare reassignment NPD
• Post Acute Wound Care Services LLC

  • Internal Medicine Physician
  • Clayton, MO
  • NPI 1154127660
  Medicare reassignment NPD
• Generation Clinical Partners LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Glen Carbon, IL
  • NPI 1366050007
  Medicare reassignment NPD
• Midwest Hospitalist Physicians LLP

  • Hospitalist Physician
  • Lima, OH
  • NPI 1891242319

  MO

  Medicare reassignment NPD
• Generation Clinical Partners Aco, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1740969120
  NPD
• Generation Clinical Partners Aco, LLC

  • Internal Medicine Physician
  • Waterloo, IL
  • NPI 1104674431
  NPD
• All Facility Management Group, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1437987039
  NPD (past)

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

• Lutheran Senior Services

  • Community Based Hospice Care Agency
  • Saint Louis, MO
  • NPI 1568592442
  Care Compare affiliation
• Lutheran Senior Services

  • Skilled Nursing Facility
  • Chesterfield, MO
  • NPI 1992160949

  Nursing home

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• Deaconess Illinois Red Bud Regional Hospital Inc

  • Critical Access Hospital
  • Red Bud, IL
  • NPI 1407573132
  Care Compare affiliation
• Lutheran Senior Services

  • Skilled Nursing Facility
  • Glen Carbon, IL
  • NPI 1932814548

  Nursing home

  Care Compare affiliation
• Monroe County

  • Skilled Nursing Facility
  • Waterloo, IL
  • NPI 1164424487

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1982968129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2566 STONE RIDGE DR",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK GROVE RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "63901",
            "telephone_number": "573-785-7721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Lafayette Ave",
            "address_purpose": "LOCATION",
            "city": "Suffern",
            "state": "NY",
            "postal_code": "109014812",
            "country_code": "US",
            "telephone_number": "573-718-1414",
            "fax_number": "845-565-3696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 Lafayette Ave",
            "address_purpose": "LOCATION",
            "city": "Suffern",
            "state": "NY",
            "postal_code": "109014812",
            "country_code": "US",
            "telephone_number": "573-718-1414",
            "fax_number": "845-565-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "EMIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2017001080",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280374",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.134257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Feece, BS,CSS
• Brandon Tyler Felps
• Carmella Fenske, CRADC
• Melissa Ferguson
• Zachary L Ferguson, PA
• Joseph P Fernando, M.D.
• Russell Fields
• Tammy Rena Fields
• Jarvis Darrel Finley
• Laura Sue Finley, RPH

• Internal Medicine Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.