Individual provider Active NPI

Mary Carmen Hernandez, PA

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1235968835
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
265 E Rollins St # 6
Orlando, FL 32804-5502
Phone
(407) 303-6729
Fax
(407) 628-2037
NPI assigned
Jul 31, 2024
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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 Primary

Addresses

Primary practice location

265 E Rollins St # 6
Orlando, FL 32804-5502

Mailing address

265 E Rollins St # 6
Orlando, FL 32804-5502
Phone (407) 303-6729

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
I20241216003997 FL Practitioner - Physician Assistant 5597292482 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Surgery and Endoscopy Centers LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1026 SE Federal Hwy
Stuart, FL 34994
Phone (772) 210-2447

325 Avenue B NW
Winter Haven, FL 33881
Phone (800) 364-9216

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mary.hernandez.1@30104.direct.athenahealth.com

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1235968835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST # 6",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045502",
            "telephone_number": "407-303-6729",
            "fax_number": "407-628-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST # 6",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045502",
            "telephone_number": "407-303-6729",
            "fax_number": "407-628-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARY",
        "middle_name": "CARMEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.