Individual provider Active NPI

Jose Noel Hernandez, P.A.

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1194878595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100229 Issued in FL
Practice address
11210 SW 188TH St
Miami, FL 33157-7529
Phone
(305) 884-8880
Fax
(305) 884-7740
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9100229 FL Primary

Addresses

Primary practice location

11210 SW 188TH St
Miami, FL 33157-7529

Mailing address

11210 SW 188TH St
Miami, FL 33157-7529
Phone (305) 884-8880

Other identifiers 1

IdentifierTypeStateIssuer
PA9100229OtherFLPHYSICIAN ASSISTANT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204000300 FL Practitioner - Physician Assistant 8123300811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hammock Medical Center IncGroup PAC ID 4082664354, 3 clinicians

Practice addresses (Care Compare)

15122 SW 72ND St
Miami, FL 33193-3228
Phone (305) 383-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9100229FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Celen Medical Center , Corp PastSince Aug 28, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194878595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11210 SW 188TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331577529",
            "telephone_number": "305-884-8880",
            "fax_number": "305-884-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 SW 188TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331577529",
            "telephone_number": "305-884-8880",
            "fax_number": "305-884-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "NOEL",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PA9100229",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.