Individual provider Active NPI

Anita Katharina Hernandez, M.D.

  • Family Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1306073986
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301107638 Issued in MI
Practice address
1801 Briarwood Circle
Ann Arbor, MI 48108-3347
Phone
(734) 998-7390
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ML60095995 WA
Family Medicine Physician 207Q00000X 35.099728 OH
Family Medicine Physician 207Q00000X 4301107638 MI Primary
Obstetrics & Gynecology Physician 207V00000X 4301107638 MI

Addresses

Primary practice location

1801 Briarwood Circle
Ann Arbor, MI 48108-3347

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 3

IdentifierTypeStateIssuer
3810023762MedicaidWV
0068432MedicaidOH
P01141863OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150721000267 MI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 4880841022 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301107638MIMDFamily Medicine Physician
35.099728OHMDFamily Medicine Physician
ML60095995WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jun 30, 2015 Accepting new patients
Regents of the University of Michigan Family Medicine CurrentSince Jun 30, 2015 Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
#700
Ann Arbor, MI 48108

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

14700 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-1321

Interoperability endpoints

  • Direct secure messaging: ahernandez663244@direct.med.umich.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1306073986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BRIARWOOD CIRCLE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083347",
            "telephone_number": "734-998-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ANITA",
        "middle_name": "KATHARINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML60095995",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.099728",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301107638",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301107638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023762",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068432",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01141863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.