Organization Active NPI

Mederna Primary Care PLLC

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1477394039
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDERNA PRIMARY CARE PLLC
Practice address
5225 Katy Fwy Ste 250
Houston, TX 77007-2200
Phone
(832) 272-0401
NPI assigned
Jun 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Ernai Hernadez Hernandez, MD
Title
MD
Phone
(832) 524-8438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5225 Katy Fwy Ste 250
Houston, TX 77007-2200

Mailing address

5225 Katy Fwy Ste 250
Houston, TX 77007-2200
Phone (832) 272-0401

Other names 1

  • Mederna Primary Care Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241016004133 TX Part B Supplier - Clinic/Group Practice 2860924750 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2337055Mederna Primary Care PLLC5225 Katy Fwy Suite 323, Houston, TX 77007Certificate of waiverJan 13, 2028

National Provider Directory

National Provider Directory

Locations

5225 Katy Fwy
Ste 323
Houston, TX 77007
Phone (832) 272-0401

5225 Katy Fwy
Ste 250
Houston, TX 77007
Phone (832) 272-0401

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1477394039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 KATY FWY STE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770072200",
            "telephone_number": "832-272-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 KATY FWY STE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770072200",
            "telephone_number": "832-272-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDERNA PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "HERNADEZ HERNANDEZ",
        "authorized_official_first_name": "ERNAI",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "832-524-8438",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mederna Primary Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.