Individual provider Active NPI

Jessa Hernandez, MD

  • Family Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1366079659
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12036900 Issued in NJ
Practice address
110 Marter Ave Ste 503
Moorestown, NJ 08057-3120
Phone
(856) 608-8840
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA12036900 NJ Primary

Addresses

Primary practice location

110 Marter Ave Ste 503
Moorestown, NJ 08057-3120

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

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
I20240205003660 NJ Practitioner - Family Practice 3971946112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

504 White Horse Pike
Haddon Heights, NJ 08035-1709
Phone (856) 546-7990

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine PC Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Cooper Family Medicine, PC Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

110 Marter Ave
Ste 503
Moorestown, NJ 08057
Phone (856) 608-8840

400 W Route 38
Fl 1
Moorestown, NJ 08057
Phone (856) 270-4001

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Interoperability endpoints

  • Direct secure messaging: jhernandez40940@direct.cooperhealth.edu

Organizations & group practices 3

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 2

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1366079659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MARTER AVE STE 503",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573120",
            "telephone_number": "856-608-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JESSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12036900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.