Active NPI
Michael Erik Hernandez, DO
- Family Medicine Physician
- Garden Grove, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A18072
- Practice address
- 12942 Harbor Blvd
Garden Grove, CA 92840-5809 - Phone
- (714) 705-2120
- NPI assigned
- Apr 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A18072 | CA | Primary |
Addresses
Primary practice location
12942 Harbor Blvd
Garden Grove, CA 92840-5809
Mailing address
12942 Harbor Blvd
Garden Grove, CA 92840-5809
Phone (714) 705-2120
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhernandez1751028@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12942 Harbor Blvd
Garden Grove, CA 92840-5809
Phone (714) 705-2120
134000 Jamboree Rd
Irvine, CA 92602-2308
Phone (714) 263-9279
1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350
2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 633-1011
2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175
Hospital & facility affiliations
- Providence at Home With Compassus Home Health, Orange County South
- Providence St. Joseph Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A18072 | CA | MD | Family Medicine Physician |
| 18072 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Family Medicine | Current | Accepting new patients |
| Providence Medical Foundation | Family Medicine | Current | Accepting new patients |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Providence Medical Foundation | Family Medicine | Past | Accepting new patients |
Locations
5630 E Santa Ana Canyon Rd
Ste 100
Anaheim, CA 92807
Phone (714) 257-6170
2251 N Harbor Blvd
Fullerton, CA 92835
Phone (714) 449-6230
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
12942 Harbor Blvd
Garden Grove, CA 92840
Phone (714) 618-9540
2501 E Chapman Ave
Ste 101
Orange, CA 92869
Phone (714) 628-3300
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1609925957
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- General Acute Care Hospital
- Eureka, CA
- NPI 1609858950
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Irvine, CA
- NPI 1396567533
-
- General Acute Care Hospital
- Orange, CA
- NPI 1912982216
-
- General Acute Care Hospital
- Orange, CA
- NPI 1558575746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1790282903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12942 HARBOR BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928405809",
"telephone_number": "714-705-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12942 HARBOR BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928405809",
"telephone_number": "714-705-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "MICHAEL",
"middle_name": "ERIK",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-12",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A18072",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mhernandez1751028@oc.providencedirect.org",
"affiliation": "N",
"address_1": "12942 Harbor Blvd",
"city": "Garden Grove",
"state": "CA",
"country_code": "US",
"postal_code": "928405809",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.