Active NPI
John Manuel Hernandez, O.D.
- Optometrist
- Huntington Park, CA
National Provider Identifier
1114954856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 7216
- Practice address
- 6134 Pacific Blvd
Huntington Park, CA 90255-2923 - Phone
- (323) 589-3381
- Fax
- (323) 583-6439
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 7216 | CA | Primary |
Addresses
Primary practice location
6134 Pacific Blvd
Huntington Park, CA 90255-2923
Mailing address
6134 Pacific Blvd
Huntington Park, CA 90255-2923
Phone (323) 589-3381
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 190545 | Other | CA | SAFEGUARD VISION |
| 3235893381 | Other | CA | VISION SERVICE PLAN |
| 903261 | Other | CA | BLOCK VISION, INC. |
| 1535 | Other | CA | CARE FIRST |
| NONE | Other | CA | THREE RIVERS PROVIDER NET |
| 165 | Other | CA | VISION PLAN OF AMERICA |
| 3351 | Other | CA | MEDICAL EYE SERVICES/ECN |
| NONE | Other | CA | ADVANTAGE HEALTH NETWORK |
| SD0072160 | Medicaid | CA | |
| CA 7216 | Other | CA | ECPA/EYEMED |
| NONE | Other | CA | SOUTH ATLANTIC MEDICAL GR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6134 Pacific Blvd
Huntington Park, CA 90255-2923
Phone (323) 589-3381
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 7216 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Judy C. Liao O.D. Inc | Optometrist | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- Optometrist
- Huntington Park, CA
- NPI 1588493795
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- Optometrist
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- NPI 1215308010
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- Optometrist
- Los Angeles, CA
- NPI 1821599358
-
- Optometrist
- Huntington Park, CA
- NPI 1740063627
Organizations & group practices 1
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": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1114954856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6134 PACIFIC BLVD",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902552923",
"telephone_number": "323-589-3381",
"fax_number": "323-583-6439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6134 PACIFIC BLVD",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902552923",
"telephone_number": "323-589-3381",
"fax_number": "323-583-6439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "JOHN",
"middle_name": "MANUEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 7216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAFEGUARD VISION",
"identifier": "190545",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "3235893381",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION, INC.",
"identifier": "903261",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST",
"identifier": "1535",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS PROVIDER NET",
"identifier": "NONE",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION PLAN OF AMERICA",
"identifier": "165",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES/ECN",
"identifier": "3351",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVANTAGE HEALTH NETWORK",
"identifier": "NONE",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0072160",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECPA/EYEMED",
"identifier": "CA 7216",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH ATLANTIC MEDICAL GR",
"identifier": "NONE",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.