Michael Hernandez, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME101094 Issued in FL

Practice address

3059 Edgewood Ave W
Jacksonville, FL 32209-2207

Phone

(305) 628-6117

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6c20d173-8471-45ee-ad2d-9ab0afd60b33/
• FHIR API: https://api.platform.athenahealth.com/26160/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/JGHHBD

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.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• Luis F Anez MD PA

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1538347380
  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• River City Nephrology PLLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1093450652
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1609929405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322092207",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9765 San Jose Blvd",
            "address_2": "STE. 102",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322574402",
            "country_code": "US",
            "telephone_number": "904-260-5757",
            "fax_number": "904-268-0733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME101094",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN9476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170121230A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2813645-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greta Katherine Hernandez
• Henry Jim Hernandez
• Jorge Elias Hernandez, MS, OTR/L, CAPS
• Lindsay Hernandez
• Lori Ann Hernandez, APRN
• Olivia Hernandez
• Shelly Vanessa Hernandez, RDH
• Stacy M Hernandez
• Stephanie Hernandez, M.ED., ED.S.
• Veronica Hernandez

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.