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DR. JESSE TELLEZ HERNANDEZ NP-C
NPI 1184099558
Nurse Practitioner in Fort Hall, ID

Active since December 10, 2015PECOS Enrolled
BUILDING 70 NAVAJO DRIVE, FORT HALL, ID 83203(208) 478-3987(208) 478-4040 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jesse Tellez Hernandez Np-c NPPES

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

DR. JESSE TELLEZ HERNANDEZ NP-C (NPI 1184099558) is an individual nurse practitioner in Fort Hall, Idaho, licensed in Idaho (NP-1663A) and active in the NPI registry since December 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184099558
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameDR. JESSE TELLEZ HERNANDEZCredential: NP-C
Location AddressBUILDING 70 NAVAJO DRIVEFort Hall, ID 83203
Mailing AddressPo Box 4414Pocatello, ID 83205-4414 · (208) 219-9927
Phone(208) 478-3987
Fax(208) 478-4040
Sole ProprietorNo
Enumeration DateDecember 10, 2015
Last NPPES UpdateMarch 30, 2022
NPPES CertifiedMarch 21, 2022
✔ NPI 1184099558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in ID · NP-1663A
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
BUILDING 70 NAVAJO DRIVE, Fort Hall, ID 83203
Open in Google Maps ↗

Other Identifiers 2

OtherNP-1663AID · Professional License
Other11948571-4405UT · Professional License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jesse Tellez Hernandez Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jesse Tellez Hernandez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shoshone Bannock Tribes, Inc
Same address
Clinic/Center
NAVAJO DRIVE BLDG 70
Fort Hall, ID 83203
  • Reassigned Medicare billing, Texas enrollment
  • 8 clinicians in this Medicare group
NPI 1225414519 (208) 478-3995

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83203 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
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.

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 Jesse Tellez Hernandez's NPI number?

The NPI number for Jesse Tellez Hernandez is 1184099558. It was assigned to this individual provider in the NPPES registry on December 10, 2015.

Where is Jesse Tellez Hernandez located?

Jesse Tellez Hernandez practices at Building 70 Navajo Drive, Fort Hall, ID 83203. The listed phone number is (208) 478-3987.

What is Jesse Tellez Hernandez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jesse Tellez Hernandez enrolled in Medicare?

Yes. Jesse Tellez Hernandez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jesse Tellez Hernandez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Tellez Hernandez reassigns Medicare benefits to Shoshone Bannock Tribes, Inc (Fort Hall, ID). 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 Jesse Tellez Hernandez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jesse Tellez Hernandez was last updated on March 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.