YELED SHALOM PEDIATRIC CLINIC
NPI 1770540684
Clinic/Center - Rural Health in Eagle Pass, TX
About Yeled Shalom Pediatric Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
YELED SHALOM PEDIATRIC CLINIC (NPI 1770540684) is a healthcare organization registered as a rural health in Eagle Pass, Texas and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through December 19, 2027 and lists Eliezer Hernandez, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Yeled Shalom Pediatric Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Yeled Shalom Pediatric Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2246002
Yeled Shalom Pediatric Clinic · Eagle Pass, TXFrequently 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 Eliezer Hernandez MD P.A.'s NPI number?
The NPI number for Eliezer Hernandez MD P.A. is 1770540684. It was assigned to this organization in the NPPES registry on April 26, 2006. The provider is doing business as Yeled Shalom Pediatric Clinic.
Where is Eliezer Hernandez MD P.A. located?
Eliezer Hernandez MD P.A. is located at 1975 N Veterans Blvd Ste. 5, Eagle Pass, TX 78852. The listed phone number is (830) 773-9449.
What is Eliezer Hernandez MD P.A.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Eliezer Hernandez MD P.A. enrolled in Medicare?
Yes. Eliezer Hernandez MD P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Eliezer Hernandez MD P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Eliezer Hernandez MD P.A.. A 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 the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Eliezer Hernandez MD P.A. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2246002) is associated with this NPI, valid through December 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Eliezer Hernandez MD P.A. accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Eliezer Hernandez MD P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Eliezer Hernandez MD P.A. was last updated on November 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Yeled Shalom Pediatric Clinic · NPI 1770540684
Rural Health organization in Eagle Pass, Texas. Organization record, active in the CMS NPPES registry since April 26, 2006.
## Identity
- **NPI:** 1770540684 (Entity type: Organization)
- **Enumerated:** April 26, 2006
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Eliezer Hernandez Md P.a.
- **Organization subpart:** No
- **Authorized official:** Eliezer Hernandez, OWNER
## Practice location
- **Address:** 1975 N VETERANS BLVD, STE. 5, Eagle Pass, TX 78852-4456
- **Phone:** (830) 773-9449 · **Fax:** (830) 757-3142
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Pediatric Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 25, 2024
- **Other identifiers:** Medicaid 063670601 (TX); Medicaid 153805002 (TX); Medicaid 153805001 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1770540684) · Data from the CMS NPPES public registry.