Individual provider Active NPI

Zachary Kris Hernandez, DO

  • Emergency Medicine Physician
  • Summit, NJ
National Provider Identifier
1245677004
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB10358000 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901
Phone
(908) 522-2000
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10358000 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901

Mailing address

16 Phyllis Dr
Succasunna, NJ 07876-1031
Phone (973) 981-3655

Other practice location 1

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-5161

Other identifiers 1

IdentifierTypeStateIssuer
1245677004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180626003625 NJ Practitioner - Emergency Medicine 5890040273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rowan University School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians

Practice addresses (Care Compare)

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2232

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as individual
Quality
64.78
Improvement activities
40
Cost
70.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10358000NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Organizations & group practices 1

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 1

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1245677004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PHYLLIS DR",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761031",
            "telephone_number": "973-981-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-522-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-5161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ZACHARY",
        "middle_name": "KRIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10358000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245677004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.