KOLTEN D HERNANDEZ – Critical Care Medicine Nurse Practitioner, NPI 1104793652

KOLTEN D HERNANDEZ is a healthcare provider. based in Mansfield, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 1218791 (TX). The NPI Number for KOLTEN D HERNANDEZ is 1104793652

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
KOLTEN D HERNANDEZ
NPI
1104793652
Phone
(682) 900-4174
Address
2800 E BROAD ST STE 204
Enumeration Date
20 October 2025
Last Update Date
19 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6829004174
Graduation Year
2025 (1 year ago)
PAC ID
3173008968
Group Practice PAC ID
2062884471
Professional Enrollment ID
I20260330003000
Address ID
TX760636416MA2800XSTXX401
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

22,204 NURSE PRACTITIONER in TX

Provider Addresses for KOLTEN D HERNANDEZ

  • 2800 E BROAD ST STE 204

    MANSFIELD, TX 760636411

    Phone: (682) 900-4174

    Fax: (682) 900-4175

    Type: Mailing

  • 2400 N I 35

    Waxahachie, TX 751655240

    Phone: (469) 843-5000

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 76063)

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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: 2062884471View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Internal Medicine, Pulmonary Disease, Critical Care (Intensivists)IA
Nurse PractitionerTX
Nurse PractitionerGA
Nurse PractitionerNY
Nurse PractitionerTX
Pulmonary DiseaseAL
Pulmonary Disease, Critical Care (Intensivists)MA
Nurse PractitionerTX

Reviews

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Frequently asked questions

How is KOLTEN D HERNANDEZ identified in CMS data?
CMS-hosted NPPES data lists KOLTEN D HERNANDEZ with NPI 1104793652.
Does the file indicate KOLTEN D HERNANDEZ is practicing under active NPI?
Directory data currently reports KOLTEN D HERNANDEZ as active.
What is KOLTEN D HERNANDEZ best known for clinically?
Directory data describes KOLTEN D HERNANDEZ with Critical Care Medicine Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect KOLTEN D HERNANDEZ on a map?
Expect Mansfield, Texas as a primary anchor for KOLTEN D HERNANDEZ unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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