KOLTEN D HERNANDEZ
NPI 1104793652
Nurse Practitioner - Critical Care Medicine in Mansfield, TX

Q: What is Kolten Hernandez's NPI number?

The NPI number for Kolten Hernandez is 1104793652. It was assigned to this individual provider in the NPPES registry on October 20, 2025.

Q: What is Kolten Hernandez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Critical Care Medicine, with taxonomy code 363LC0200X.

Q: When was this NPI record last updated?

The NPPES record for Kolten Hernandez was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since October 20, 2025PECOS EnrolledAccepts Medicare Assignment

2800 E BROAD ST STE 204, MANSFIELD, TX 76063(682) 900-4174(682) 900-4175 Get Directions Write a Review

NPPES record last updated: January 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kolten D Hernandez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOLTEN D HERNANDEZ (NPI 1104793652) is an individual critical care medicine provider in Mansfield, Texas, licensed in Texas (1218791) and active in the NPI registry since October 2025. He is enrolled in Medicare PECOS, is affiliated with Texas Health Huguley Hospital Fort Worth South, and maintains a secondary practice location in Waxahachie.

NPPES Registry Identity

NPI1104793652

Entity TypeIndividualMale

Primary Taxonomy363LC0200X

Provider Legal NameKOLTEN D HERNANDEZ

Location Address2800 E BROAD ST STE 204Mansfield, TX 76063-6411

Mailing Address2800 E Broad St Ste 204Mansfield, TX 76063-6411 · (682) 900-4174 · Fax (682) 900-4175

Phone(682) 900-4174

Fax(682) 900-4175

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 20, 2025

Last NPPES UpdateJanuary 19, 2026

NPPES CertifiedJanuary 19, 2026

✔ NPI 1104793652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Critical Care MedicinePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LC0200X

License✔ Licensed in TX · 1218791

2800 E BROAD ST STE 204, Mansfield, TX 76063

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Secondary Practice Location 1

Location 12400 N I 35Waxahachie, TX 75165-5240 · Phone (469) 843-5000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kolten D Hernandez 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.

PECOS PAC ID3173008968

PECOS Enrollment IDI20260330003000

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Huguley Hospital Fort Worth South

Acute Care Hospitals · Burleson, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450677

Location11801 South FreewayBurleson, TX 76028 · Johnson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76063 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BABATUNDE O. KOMOLAFE MD

Internal Medicine (Interventional Cardiology)