Individual provider Active NPI

Alfonso Claudio Hernandez, M.D, M.P.H.

  • Infectious Disease Physician
  • Atlanta, GA
National Provider Identifier
1164818092
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
78368 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd Ste 330
Atlanta, GA 30342-5023
Phone
(404) 459-0002
Fax
(404) 459-0003
NPI assigned
Apr 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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
Infectious Disease Physician 207RI0200X 78368 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd Ste 330
Atlanta, GA 30342-5023

Mailing address

5673 Peachtree Dunwoody Rd Ste 330
Atlanta, GA 30342-5023
Phone (404) 459-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210723002576 GA Practitioner - Infectious Disease 2264835560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

5673 Peachtree Dunwoody Rd
Suite 330
Atlanta, GA 30342-5023
Phone (404) 459-0002

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78368GAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Mar 19, 2021 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Mar 19, 2021 Accepting new patients

Locations

5673 Peachtree Dunwoody Rd
Ste 330
Sandy Springs, GA 30342
Phone (404) 459-0002

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

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.

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1164818092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD STE 330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425023",
            "telephone_number": "404-459-0002",
            "fax_number": "404-459-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD STE 330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425023",
            "telephone_number": "404-459-0002",
            "fax_number": "404-459-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ALFONSO",
        "middle_name": "CLAUDIO",
        "credential": "M.D, M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "78368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.