NPIMap

Individual provider Active NPI

Maurilio Hernandez, M.D.

  • Family Medicine Physician
  • Imlay City, MI
National Provider Identifier
1154550911
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301095103 Issued in MI
Practice address
1834 S Cedar St Ste a
Imlay City, MI 48444-9779
Phone
(810) 721-0000
Fax
(810) 721-0003
NPI assigned
Jul 14, 2009
Last updated
Dec 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301095103 MI Primary

Addresses

Primary practice location

1834 S Cedar St Ste a
Imlay City, MI 48444-9779

Mailing address

1834 S Cedar St
Ste a
Imlay City, MI 48444-9779
Phone (586) 727-2761

Other identifiers 2

IdentifierTypeStateIssuer
1154550911MedicaidMI
1235131137OtherMIBCBSM - BRONSON

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhernandez219022@direct.hfhs.org Henry Ford Macomb Hospital Corporation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120921000752 MI Practitioner - Family Practice 8123276821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1834 S Cedar St
Imlay City, MI 48444-9779
Phone (810) 721-0000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alxmh LLC Family Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

1834 S Cedar St
Imlay City, MI 48444
Phone (810) 721-0000

1834 S Cedar St
Ste A
Imlay City, MI 48444
Phone (586) 745-3006

1834 S Cedar St
Ste B
Imlay City, MI 48444
Phone (810) 721-0000

Interoperability endpoints

  • Direct secure messaging: mhernandez219022@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1154550911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 S CEDAR ST",
            "address_2": "STE A",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484449779",
            "telephone_number": "586-727-2761",
            "fax_number": "586-727-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 S CEDAR ST STE A",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484449779",
            "telephone_number": "810-721-0000",
            "fax_number": "810-721-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MAURILIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301095103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154550911",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON",
            "identifier": "1235131137",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhernandez219022@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Macomb Hospital Corporation",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Imlay City, MI

Sources for this page

Verify at the official NPI Registry.