Active NPI
Mark Edward Hernandez, M.D.
- Family Medicine Physician
- Sandpoint, ID
National Provider Identifier
1457416224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M6092
- Practice address
- 302 S 1St Ave
Sandpoint, ID 83864-1258 - Phone
- (208) 263-5109
- Fax
- (208) 263-5112
- NPI assigned
- Dec 22, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M6092 | ID | Primary |
Addresses
Primary practice location
302 S 1St Ave
Sandpoint, ID 83864-1258
Mailing address
290 Ponder Point Dr
Sandpoint, ID 83864-8657
Phone (208) 263-1588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002717200 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Baylor College of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
302 S 1St Ave
Sandpoint, ID 83864-1258
Phone (208) 263-5109
Hospital & facility affiliations
- Eden Home Health
- Welcome Home Healthcare Services, LLC
- Bonner General Hospital
- Boundary Community Hospital
- Kootenai Health
- Northwest Specialty Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 15 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6092 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandpoint Family Medicine PA | Family Medicine | Current | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72489
- mark.hernandez@sfm.directbygreenway.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sandpoint Family Medicine & Urgent Care
- Family Medicine Physician
- Sandpoint, ID
- NPI 1740493832
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Bonner General Health
- Critical Access Hospital
- Sandpoint, ID
- NPI 1154563963
-
- Critical Access Hospital
- Bonners Ferry, ID
- NPI 1801896683
-
dba Eden Home Health
- Home Health Agency
- Ponderay, ID
- NPI 1346898830
-
- General Acute Care Hospital
- Coeur d'Alene, ID
- NPI 1992798409
-
dba Northwest Specialty Hospital
- General Acute Care Hospital
- Post Falls, ID
- NPI 1104824739
-
- Sleep Medicine (Psychiatry & Neurology) Physician
- Post Falls, ID
- NPI 1649123589
Hospital
-
- Home Health Agency
- Sandpoint, ID
- NPI 1467808048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457416224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 PONDER POINT DR",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838648657",
"telephone_number": "208-263-1588",
"fax_number": "208-263-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 S 1ST AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641258",
"telephone_number": "208-263-5109",
"fax_number": "208-263-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "MARK",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M6092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002717200",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.