Individual provider Active NPI

Jonathan Robert Hernandez, DO

  • Family Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1043951718
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101028436 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 982-4941
NPI assigned
Apr 5, 2022
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 5101028436 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1335 Pine Hill CT
Saint Joseph, MI 49085-2830
Phone (269) 207-2082

Other practice location 1

400 Medical Park Dr Ste 200
Watervliet, MI 49098-9225
Phone (269) 463-3600

Other practice location 2

5515 Cleveland Ave Ste 5
Stevensville, MI 49127-9669
Phone (269) 429-9644

Other practice location 3

2002 S 11th St
Niles, MI 49120-4074
Phone (269) 687-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625000745 MI Practitioner - Family Practice 3476999079 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Community Hospital WatervlietGroup PAC ID 7416942750, shared by 7 NPIs, 66 clinicians

Practice addresses (Care Compare)

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 463-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Single Specialty Current Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jul 1, 2025 Accepting new patients
Lakeland Community Hospital Watervliet Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Lakeland Medical Practices Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Lakeland Community Hospital Watervliet Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Lakeland Medical Practices CurrentSince Jul 1, 2025 Accepting new patients

Locations

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

400 Medical Park Dr
Ste 200
Watervliet, MI 49098
Phone (269) 463-4000

460 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3733

460 Medical Park Dr
Ste 200
Watervliet, MI 49098

Interoperability endpoints

  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1043951718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 PINE HILL CT",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852830",
            "telephone_number": "269-207-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-982-4941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Medical Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "MI",
            "postal_code": "490989225",
            "country_code": "US",
            "telephone_number": "269-463-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5515 Cleveland Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MI",
            "postal_code": "491279669",
            "country_code": "US",
            "telephone_number": "269-429-9644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2002 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491204074",
            "country_code": "US",
            "telephone_number": "269-687-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101028436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.