Individual provider Active NPI

Daniel Hernandez, O.D.

  • Optometrist
  • Sunrise, FL
National Provider Identifier
1962593749
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2769 Issued in FL
Practice address
4181 N Pine Island Rd
Sunrise, FL 33351-6040
Phone
(954) 909-4444
Fax
(954) 909-4455
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2769 FL Primary

Addresses

Primary practice location

4181 N Pine Island Rd
Sunrise, FL 33351-6040

Mailing address

4181 N Pine Island Rd
Sunrise, FL 33351-6040
Phone (954) 909-4444

Other identifiers 1

IdentifierTypeStateIssuer
620048600MedicaidFL

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080222000023 FL Practitioner - Optometry 4486738986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2769FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Vision Care Inc Optometrist CurrentSince Jul 1, 2019 Accepting new patients

Locations

2873 Stirling Rd
Ft Lauderdale, FL 33312
Phone (954) 983-4969

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1962593749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 N PINE ISLAND RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516040",
            "telephone_number": "954-909-4444",
            "fax_number": "954-909-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 N PINE ISLAND RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516040",
            "telephone_number": "954-909-4444",
            "fax_number": "954-909-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620048600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.