Individual provider Active NPI

Jason E Hernandez, M.D.

  • Pediatric Cardiology Physician
  • Hackensack, NJ
National Provider Identifier
1992236285
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
25MA10840300 Issued in NJ
Practice address
155 Polifly Rd Ste 106
Hackensack, NJ 07601-1749
Phone
(201) 441-9980
NPI assigned
Mar 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 4301504718 MI
Pediatric Cardiology Physician 2080P0202X 25MA10840300 NJ Primary

Addresses

Primary practice location

155 Polifly Rd Ste 106
Hackensack, NJ 07601-1749

Mailing address

331 Newman Springs Rd
BLDG 2 , Suite 220
Neptune, NJ 07753
Phone (732) 807-0877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211227000563 MI Practitioner - Pediatric Medicine 9335541390 Reassigns benefits to 1 organization
I20240618001048 NJ Practitioner - Pediatric Medicine 9335541390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

155 Polifly Rd
Hackensack, NJ 07601-1758
Phone (201) 487-7617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301504718MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC Pediatrics CurrentSince Jun 7, 2024 Accepting new patients
Spectrum Health Primary Care Partners Pediatric Cardiology CurrentSince Dec 15, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 7, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 15, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Pediatrics Past Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

155 Polifly Rd
Ste 106
Hackensack, NJ 07601
Phone (201) 441-9980

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

155 Polifly Rd
Hackensack, NJ 07601
Phone (201) 343-6360

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1992236285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2 , SUITE 220",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-807-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 POLIFLY RD STE 106",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011749",
            "telephone_number": "201-441-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JASON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301504718",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "25MA10840300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.