ANDREW HERNANDEZ – Psychiatric/Mental Health Nurse Practitioner, NPI 1104709005

ANDREW HERNANDEZ is a healthcare provider. based in Grand island, Nebraska. specializing in NURSE PRACTITIONER. They hold a License No. 116085 (NE). The NPI Number for ANDREW HERNANDEZ is 1104709005

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ANDREW HERNANDEZ
NPI
1104709005
Phone
(562) 385-3282
Address
103 E 18TH ST
Enumeration Date
28 July 2025
Last Update Date
28 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3088652249
Graduation Year
2025 (1 year ago)
PAC ID
5698270825
Group Practice PAC ID
1850285255
Professional Enrollment ID
I20250926002356
Address ID
NE688458300KE1755XPLXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,112 NURSE PRACTITIONER in NE

Provider Addresses for ANDREW HERNANDEZ

  • 103 E 18TH ST

    GRAND ISLAND, NE 688012303

    Phone: (562) 385-3282

    Type: Mailing

  • 1755 PRAIRIE VIEW PL

    KEARNEY, NE 688458300

    Phone: (308) 865-2249

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250926002356INurse PractitionerNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850285255View full group profile

Reviews

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Frequently asked questions

Can I cross-check ANDREW HERNANDEZ using NPI 1104709005?
NPI 1104709005 belongs to ANDREW HERNANDEZ; compare other details if you need extra assurance.
Is ANDREW HERNANDEZ shown as active in public data?
Registry records indicate ANDREW HERNANDEZ maintains an active NPI.
What area of care is associated with ANDREW HERNANDEZ?
ANDREW HERNANDEZ's record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is ANDREW HERNANDEZ associated with Grand Island?
Public fields place ANDREW HERNANDEZ around Grand Island, Nebraska. Always confirm the exact site before visiting.
Can I trust this NPI listing for ANDREW HERNANDEZ?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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