Eliezer Hernandez

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

348045 Issued in NY

Practice address

553 Clinton Ave
Albany, NY 12206-2738

Phone

(518) 689-0282

Fax

(518) 689-0283

NPI assigned

Aug 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Koinonia Primary Care IncGroup PAC ID 6901041425, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBHGAA

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.

• Koinonia Primary Care Inc

  • Clinic/Center
  • Albany, NY
  • NPI 1023389533
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1679247159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 CLINTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062738",
            "telephone_number": "518-689-0282",
            "fax_number": "518-689-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 CLINTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062738",
            "telephone_number": "518-689-0282",
            "fax_number": "518-689-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ELIEZER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "348045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L Herkenham
• Lorraine Ann Herkenham, RPH
• Gabrielle Maria Herman, LMHC-D
• Kayla Herman
• Ashley Catherine Hernandez, MS, RD, CSR, CDN
• Natalia Hernandez, MD
• Rion Heroux
• Elizabeth Z Herr, LMSW
• Caleb Herrick, MD
• Susan Lynn Herrick

• Primary Care Nurse Practitioner in Albany, NY
• Providers in Albany, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.

Verify at the official NPI Registry.