PATRICIA ISELA HERRERA FNP
NPI 1902304801
Family Medicine in Phoenix, AZ

NPI Status: Active since January 25, 2018

Contact Information

521 W THOMAS RD
PHOENIX, AZ
ZIP 85013
Phone: (602) 254-0390
Fax: (888) 846-8757

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  • Individual
  • Female
  • Years of Experience 9
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment

About PATRICIA HERRERA

This page provides the complete NPI Profile along with additional information for Patricia Herrera, a primary care provider established in Phoenix, Arizona with a medical specialization in Family Medicine and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1902304801 assigned on January 2018. The practitioner's primary taxonomy code is 207Q00000X with license number 1508829326 (AZ). The provider is registered as an individual and her NPI record was last updated 8 years ago.

NPI
1902304801
Provider Name
PATRICIA ISELA HERRERA FNP
Gender
Female
Entity Type
Individual
Location Address
521 W THOMAS RD PHOENIX, AZ 85013
Location Phone
(602) 254-0390
Location Fax
(888) 846-8757
Mailing Address
4148 N 4TH AVE PHOENIX, AZ 85013
Mailing Phone
(602) 828-2364
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
No
Enumeration Date
01-25-2018
Last Update Date
01-25-2018
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A primary care provider (PCP) like Patricia Herrera sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
1508829326
License State
AZ
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • Blue ACA StandardHealth Silver with Health Choice - HMO
  • Blue Portfolio HSA Gold - Statewide PPO Network - PPO
  • Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
  • Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
  • Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
  • Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
  • Imperial Preferred Gold - HMO
  • Imperial Preferred Silver - HMO
  • Imperial Standard Bronze - HMO
  • Imperial Standard Gold - HMO
  • Imperial Standard Silver - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Patricia Herrera is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 3779848932

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180711003677

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.47 for a new patient copayment and $24.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 85013 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.89
  • Minimum New Patient Price $55.44
  • Maximum New Patient Price $168.6
  • Average New Patient Copayment $21.47
  • Minimum New Patient Copayment $13.86
  • Maximum New Patient Copayment $42.15

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $98
  • Minimum Established Patient Price $17.72
  • Maximum Established Patient Price $137.41
  • Average Established Patient Copayment $24.5
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $34.35

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for PATRICIA ISELA HERRERA FNP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1902304801
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
290260880
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 6 + 0 + 8 + 8 + 0 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1902304801 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1164427605 LINDA LOU HOLLAND-OJEDA F.N.P.
Individual
Nurse Practitioner (Family)521 W THOMAS RD
PHOENIX, AZ 85013
(602) 254-0390
1396709762 PATRICK ARAMBULA MD
Individual
Pediatrics521 W THOMAS RD 2ND FLOOR
PHOENIX, AZ 85013
(602) 867-1252
1750579041 HAO HAO YUAN RN, CPNP, MSN
Individual
Nurse Practitioner (Pediatrics)521 W THOMAS RD
PHOENIX, AZ 85013
(602) 254-0390
1508829326KIDS KARE PEDIATRICS PC
Organization
Pediatrics521 W THOMAS RD 2ND FLOOR
PHOENIX, AZ 85013
(602) 867-1252
1518910066DR. GEORGE RAYMOND AYOUB DDS
Individual
Dentist (General Practice)521 W THOMAS RD FIRST FLOOR
PHOENIX, AZ 85013
(602) 307-5775
1790191401 TAMI HAMPSON FNP
Individual
Nurse Practitioner (Family)521 W THOMAS RD 2ND FLOOR
PHOENIX, AZ 85013
(602) 254-0390
1477939866 LARISSA BECH MSN, RN, FNP
Individual
Nurse Practitioner (Family)521 W THOMAS RD
PHOENIX, AZ 85013
(602) 254-0390
1699144857KIDS KARE PEDIATRICS
Organization
Point of Service521 W THOMAS RD
PHOENIX, AZ 85013
(602) 254-0390
1952309320DR. CARLOS JAVIER LOPEZ M.D.
Individual
Pediatrics521 W THOMAS RD 2ND FLOOR
PHOENIX, AZ 85013
(602) 264-3133
1841029469 ELIZABETH VELAZQUEZ ZALDIVAR PA
Individual
Physician Assistant521 W THOMAS RD
PHOENIX, AZ 85013
(602) 254-0390

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902304801, enumerated in the NPI registry as an "individual" on January 25, 2018

The provider is located at 521 W Thomas Rd Phoenix, Az 85013 and the phone number is (602) 254-0390

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 9 years of experience.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Antidote. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Medicare beneficiaries should expect a typical cost of $85.89 with an average copayment of $21.47 for new patient appointments. Established patients should expect a typical charge of $98 and an average copayment of 24.5. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on January 25, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.