Individual provider Active NPI

Maria Gloria Hernandez, M.D.

  • Pediatrics Physician
  • Sulphur, LA
National Provider Identifier
1083928055
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.206549 Issued in LA
Practice address
600 Cypress St
Sulphur, LA 70663-5052
Phone
(337) 477-0935
Fax
(337) 528-2034
NPI assigned
Aug 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME117937 FL
Pediatrics Physician 208000000X MD.206549 LA Primary

Addresses

Primary practice location

600 Cypress St
Sulphur, LA 70663-5052

Mailing address

600 Cypress St
Sulphur, LA 70663-5052
Phone (337) 513-9966

Other practice location 1

2700 Healing Way Ste 303
Wesley Chapel, FL 33543-5471
Phone (813) 929-5380

Other identifiers 1

IdentifierTypeStateIssuer
1948195MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200317001102 FL Practitioner - Pediatric Medicine 1759719289 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.206549LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc CurrentSince Apr 27, 2020 Accepting new patients
Florida Urology Partners, LLP CurrentSince Apr 27, 2020 Accepting new patients

Locations

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

26827 Foggy Creek Rd
Ste 101
Wesley Chapel, FL 33544
Phone (813) 973-7774

2700 Healing Way
Ste 303
Wesley Chapel, FL 33543
Phone (813) 607-4655

Interoperability endpoints

  • Direct secure messaging: mariahernandezaviles@tpcsl.allscriptsdirect.net
  • Direct secure messaging: mhernandez74000@adventhealth.direct-ci.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1083928055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CYPRESS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635052",
            "telephone_number": "337-513-9966",
            "fax_number": "337-528-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CYPRESS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635052",
            "telephone_number": "337-477-0935",
            "fax_number": "337-528-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Healing Way Ste 303",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335435471",
            "country_code": "US",
            "telephone_number": "813-929-5380",
            "fax_number": "813-929-5991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIA",
        "middle_name": "GLORIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME117937",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.206549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1948195",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

Verify at the official NPI Registry.