Organization Active NPI

Martin Jay Hernandez MD PC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1932271996
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31880 Issued in AZ
Legal business name
MARTIN JAY HERNANDEZ MD PC
Practice address
711 E Missouri Ave
Suite 190
Phoenix, AZ 85014-2841
Phone
(623) 936-3223
Fax
(623) 936-4554
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
Martin Jay Hernandez, MD
Title
Owner
Phone
(623) 936-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 31880 AZ Primary

Addresses

Primary practice location

711 E Missouri Ave
Suite 190
Phoenix, AZ 85014-2841

Mailing address

711 E Missouri Ave
Suite 190
Phoenix, AZ 85014-2841
Phone (623) 936-3223

Other identifiers 1

IdentifierTypeStateIssuer
1932271996OtherAZMEDICARE NPI

National Provider Directory

National Provider Directory

Locations

9305 W Thomas Rd
Ste 475
Phoenix, AZ 85037
Phone (623) 936-3223

711 E Missouri Ave
Ste 190
Phoenix, AZ 85014
Phone (623) 936-3223

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1932271996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E MISSOURI AVE",
            "address_2": "SUITE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142841",
            "telephone_number": "623-936-3223",
            "fax_number": "623-936-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E MISSOURI AVE",
            "address_2": "SUITE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142841",
            "telephone_number": "623-936-3223",
            "fax_number": "623-936-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN JAY HERNANDEZ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-936-3223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "31880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1932271996",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.