Jorge Fernandez, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5020301 Issued in NC

Practice address

3809 Computer Dr Ste 200
Raleigh, NC 27609-6518

Phone

(919) 782-3782

Fax

(919) 782-3788

NPI assigned

Oct 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of North Raleigh, PLLCGroup PAC ID 1456607852, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Integrated Dermatology of North Raleigh, PLLC

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1447748819
  Medicare reassignment Care Compare group NPD
• Ana T Sauceda MD PLLC

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1578897203
  Medicare reassignment NPD
• Andrus & Associates Dermatology, PA

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1346290590
  NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1992421325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DARTMOUTH RD APT 512",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098416",
            "telephone_number": "956-740-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-782-3782",
            "fax_number": "919-782-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JORGE",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-17",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernandez Community Center, LLC
• Fernandez Community Services
• Fernandez Familia Clinic
• Anthony Michael Fernandez, CCC-SLP
• Elise Milagros Fernandez, LPC
• Rachel Fernandez, CFO
• Sarah Lolli Fernandez, PA-C
• Eugenia Fernando
• Carroll Fernstrom, OT
• Isabel Maria Ferrall, MD

• Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.