Richard Hernandez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME58637 Issued in FL

Practice address

6100 Minton Rd NW Ste 104
Palm Bay, FL 32907-1900

Phone

(321) 724-1172

Fax

(321) 984-7695

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• Omni Healthcare, Inc.

  • Specialist
  • Melbourne, FL
  • NPI 1134191323
  Medicare reassignment
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teecnospos, AZ
  • NPI 1477615789
  NPD

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1194701540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 BULLDOG BLVD STE 202",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013188",
            "telephone_number": "321-727-2990",
            "fax_number": "321-724-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 MINTON RD NW STE 104",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071900",
            "telephone_number": "321-724-1172",
            "fax_number": "321-984-7695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 N Wickham Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329402028",
            "country_code": "US",
            "telephone_number": "321-253-4032",
            "fax_number": "321-253-4125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME58637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252234900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heritage Companion Care, LLC
• Yailin Hernandez Gonzalez
• Karla Denisse Hernandez Martinez, PHARMD
• David Hernandez
• Kaesly B Hernandez
• Mallory Kathleen Herndon
• Walt Hersing, L.C.S.W.
• Anthony Jay Herzog, MD
• Jennifer Hesly, PHARMD
• Hetherington Therapy

• Family Medicine Physician in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.