Individual provider Active NPI

Jonathan M Hernandez, M.D.

  • Surgery Physician
  • Tampa, FL
National Provider Identifier
1487843405
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D85426 Issued in MD
Practice address
2 Columbia Dr
J402
Tampa, FL 33606-3508
Phone
(813) 844-7412
NPI assigned
Oct 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN8889 FL
Surgery Physician 208600000X D85426 MD Primary

Addresses

Primary practice location

2 Columbia Dr
J402
Tampa, FL 33606-3508

Mailing address

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 848-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180612002523 MD Practitioner - Gastroenterology 6305004516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Florida College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll Health Group LLCGroup PAC ID 3870627029, 68 clinicians

Practice addresses (Care Compare)

295 Stoner Ave
Suite 102
Westminster, MD 21157-5662
Phone (410) 848-1818

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.16 of 100Reported as group
Quality
75.05
Promoting interoperability
100
Improvement activities
40
Cost
68.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D85426MDMDSurgery Physician
TRN8889FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Health Group, LLC Surgery CurrentSince May 2, 2018 Accepting new patients
Carroll Health Group, LLC Surgery PastSince Apr 27, 2025 Accepting new patients

Locations

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

295 Stoner Ave
Ste 102
Westminster, MD 21157
Phone (410) 848-1818

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.

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1487843405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575726",
            "telephone_number": "410-848-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "J402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN8889",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D85426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.