HECTOR KEVIN GONZALEZ FAJARDO MD
NPI 1104322056
Internal Medicine in Waycross, GA
About Hector Kevin Gonzalez Fajardo Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HECTOR KEVIN GONZALEZ FAJARDO MD (NPI 1104322056) is an individual internal medicine provider in Waycross, Georgia, licensed in Georgia (87737) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Hector Kevin Gonzalez Fajardo Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Hector Gonzalez Fajardo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Monroe, GA 30655
- Reassigned Medicare billing, Georgia enrollment
- 777 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension St Vincent's Riverside
Acute Care Hospitals · Jacksonville, FLMemorial Satilla Health
Acute Care Hospitals · Waycross, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 31501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WAYCROSS, GA 31501
WAYCROSS, GA 31501
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Hector Gonzalez Fajardo's NPI number?
The NPI number for Hector Gonzalez Fajardo is 1104322056. It was assigned to this individual provider in the NPPES registry on March 31, 2018.
Where is Hector Gonzalez Fajardo located?
Hector Gonzalez Fajardo practices at 1900 Tebeau St, Waycross, GA 31501. The listed phone number is (912) 283-3030.
What is Hector Gonzalez Fajardo's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Hector Gonzalez Fajardo enrolled in Medicare?
Yes. Hector Gonzalez Fajardo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Hector Gonzalez Fajardo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Hector Gonzalez Fajardo reassigns Medicare benefits to Hospital Physician Services - Southeast Professional Corporation (Monroe, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hector Gonzalez Fajardo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Hector Gonzalez Fajardo affiliated with any hospitals?
According to CMS data, Hector Gonzalez Fajardo is affiliated with Ascension St Vincent's Riverside and Memorial Satilla Health.
When was this NPI record last updated?
The NPPES record for Hector Gonzalez Fajardo was last updated on August 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Hector Kevin Gonzalez Fajardo, MD · NPI 1104322056
Internal Medicine physician in Waycross, Georgia. Individual provider, active in the CMS NPPES registry since March 31, 2018.
## Identity
- **NPI:** 1104322056 (Entity type: Individual)
- **Enumerated:** March 31, 2018
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 87737 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1900 TEBEAU ST, Waycross, GA 31501-6357
- **Phone:** (912) 283-3030
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Hospital Physician Services - Southeast Professional Corporation (NPI 1760410385, Monroe, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** August 9, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104322056) · Data from the CMS NPPES public registry.