Angelica Emili Hernandez Mondragon

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4351050877APP23 Issued in MI

Practice address

220 Cherry St SE
Grand Rapids, MI 49503-4608

Phone

(616) 685-5050

Fax

(616) 685-3033

NPI assigned

Apr 14, 2023

Sex

Female

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 MI

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)

Enrolled

State licenses

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1871289553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5050",
            "fax_number": "616-685-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034608",
            "telephone_number": "616-685-5050",
            "fax_number": "616-685-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ MONDRAGON",
        "first_name": "ANGELICA",
        "middle_name": "EMILI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4351050877APP23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Herman, PA
• Clayton Reed Hermann, BA
• Jack Robert Hermann, PHARMD
• Margaret Hermann, NP
• Rebekah Grace Hermenitt, LLBSW
• Anabel Hernandez-Gomez
• Erick Zain Hernandez-Morales, DPT
• Falicia Rene Hernandez
• Giovanni Hernandez
• Gredys Hernandez

• Neurology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.