Individual provider Active NPI

Jessica Marie Hernandez

  • Optometrist
  • Swampscott, MA
National Provider Identifier
1982334363
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5603 Issued in MA
Practice address
423 Paradise Rd
Swampscott, MA 01907-1333
Phone
(339) 440-5105
NPI assigned
Jun 16, 2022
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5603 MA Primary

Addresses

Primary practice location

423 Paradise Rd
Swampscott, MA 01907-1333

Mailing address

423 Paradise Rd
Swampscott, MA 01907-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240812000663 MA Practitioner - Optometry 9436697315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Massachusetts Professional PCGroup PAC ID 6901282557, 44 clinicians

Practice addresses (Care Compare)

423 Paradise Rd
Swampscott, MA 01907-1333
Phone (339) 440-5105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5603MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Massachusetts Professional PC Optometrist CurrentSince May 30, 2024 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

15 Central St
Andover, MA 01810
Phone (978) 475-5252

423 Paradise Rd
Swampscott, MA 01907
Phone (339) 440-5105

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1982334363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 PARADISE RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 PARADISE RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071333",
            "telephone_number": "339-440-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swampscott, MA

Sources for this page

Verify at the official NPI Registry.