Individual provider Active NPI

Victor Fabio Hernandez, MD

  • Child & Adolescent Psychiatry Physician
  • West New York, NJ
National Provider Identifier
1518904036
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
25MA06477100 Issued in NJ
Practice address
301 60TH St
Lower Level
West New York, NJ 07093-5422
Phone
(201) 295-3033
Fax
(201) 295-8592
NPI assigned
Jun 1, 2006
Last updated
Mar 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 25MA06477100 NJ Primary

Addresses

Primary practice location

301 60TH St
Lower Level
West New York, NJ 07093-5422

Mailing address

301 60TH St
Lower Level
West New York, NJ 07093-5422
Phone (201) 295-3033

Other identifiers 1

IdentifierTypeStateIssuer
7538308MedicaidNJ

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
I20051007000262 NJ Practitioner - Psychiatry 0446275614 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Association of Essex and Morris, Inc.Group PAC ID 5597654293, 14 clinicians

Practice addresses (Care Compare)

301 60TH St
Suite 2
West New York, NJ 07093-5422
Phone (201) 295-3033

33 S Fullerton Ave
Montclair, NJ 07042-3358
Phone (973) 509-9777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC CurrentSince Sep 1, 2015 Accepting new patients
Mental Health Association of Essex and Morris, Inc. CurrentSince Jul 3, 2010 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

33 S Fullerton Ave
Montclair, NJ 07042
Phone (973) 509-9777

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Interoperability endpoints

  • Direct secure messaging: vhernandez@mhaessexmorris.medalliesdirect.net
  • Direct secure messaging: victorhernandez@hmm.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1518904036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 60TH ST",
            "address_2": "LOWER LEVEL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935422",
            "telephone_number": "201-295-3033",
            "fax_number": "201-295-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 60TH ST",
            "address_2": "LOWER LEVEL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935422",
            "telephone_number": "201-295-3033",
            "fax_number": "201-295-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "VICTOR",
        "middle_name": "FABIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA06477100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7538308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

Verify at the official NPI Registry.