NPIMap

Individual provider Active NPI

Eric Moore Hernandez, M.D., PH.D.

  • Neurology Physician
  • Willmar, MN
National Provider Identifier
1154514487
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
50852 Issued in MN
Practice address
101 Willmar Ave SW
Willmar, MN 56201-3556
Phone
(320) 231-5000
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 50852 MN Primary

Addresses

Primary practice location

101 Willmar Ave SW
Willmar, MN 56201-3556

Mailing address

2828 Chicago Avenue
Suite 320
Minneapolis, MN 55407-1544
Phone (612) 879-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehernandez326359@direct.centracare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001049 MN Practitioner - NeurologyPractitioner - Other (Physician) 1557553351 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50852MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Oct 1, 2022 Accepting new patients
Quest Diagnostics LLC Il Past Accepting new patients

Locations

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1154514487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVENUE",
            "address_2": "SUITE 320",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071544",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013556",
            "telephone_number": "320-231-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ERIC",
        "middle_name": "MOORE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "50852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehernandez326359@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ehernandez326359@direct.centracare.com",
            "address_1": "101 Willmar Ave SW",
            "city": "Willmar",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562013556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.