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NPI Code Detail

MEDICARE: RICHARD A. HERNANDEZ PA-C

MEDICARE: RICHARD A. HERNANDEZ PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA00382RI
2363AM0700XMedical Physician AssistantPA00382RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA00382OTHERRIPA LICENSE

General Provider Information

NPI Number : 1457328221
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD A. HERNANDEZ PA-C
Provider Business Mailing Address
First Line : PO BOX 16149
Second Line :
City : RUMFORD
State : RI
Zip : 02916-0697
Country : US
Telephone Number : 401-453-9625
Fax Number : 401-435-7069
Provider Business Practice Location Address
First Line : 164 SUMMIT AVE # C70
Second Line :
City : PROVIDENCE
State : RI
Zip : 02906-2853
Country : US
Telephone Number : 401-793-4545
Fax Number : 401-793-7866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 01/23/2026

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