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MARIDEL AILEEN HERNANDEZ DO
NPI 1023013711
Internal Medicine in Saint Clair Shores, MI

Active since June 17, 2005PECOS EnrolledAccepts Medicare Assignment
19603 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080(586) 445-7900(586) 445-7940 Get Directions Write a Review

NPPES record last updated: October 19, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Maridel Aileen Hernandez Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIDEL AILEEN HERNANDEZ DO (NPI 1023013711) is an individual internal medicine provider in Saint Clair Shores, Michigan, licensed in Michigan (5101012021) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (1993).

NPPES Registry Identity

NPI1023013711
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMARIDEL AILEEN HERNANDEZCredential: DO
Location Address19603 E 8 MILE RDSaint Clair Shores, MI 48080-1655
Mailing Address19603 E 8 Mile RdSaint Clair Shores, MI 48080-1655 · (586) 445-7900 · Fax (586) 445-7940
Phone(586) 445-7900
Fax(586) 445-7940
Sole ProprietorYes
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1993
Enumeration DateJune 17, 2005
Last NPPES UpdateOctober 19, 2009
✔ NPI 1023013711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 5101012021
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
19603 E 8 MILE RD, Saint Clair Shores, MI 48080
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Other Names 1

Other Name (5)Maridel Aileen Hernandez D.o.

Other Identifiers 5

Other1158213464MI · Bcbs Of Mi
Medicare ID-Type UnspecifiedOP26860001MI
Medicare UPING60866
Medicaid4869383MI
Other0E02258MI · Bcbs Pin

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Maridel Aileen Hernandez Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022032366
PECOS Enrollment IDI20060127000359
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Maridel Hernandez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Maridel Hernandez Internal Medicine PC
5.9 mi
Internal Medicine
131 KERCHEVAL AVE, SUITE 120
Grosse Pointe Farms, MI 48236
  • Reassigned Medicare billing, Michigan enrollment
NPI 1366526378 (313) 640-8400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
192 services91 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
157 services90 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
48 services48 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
46 services22 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
43 services34 patients
Testing for presence of drug, read by direct observation 80305
Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.
25 services18 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230047
Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County
Emergency services Birthing friendly

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%159 patients5/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
100%52 patients5/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months
100%59 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%189 patients5/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
100%159 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%1,194 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,194 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers28 claims79 services$5.85 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
4 suppliers68 claims69 services$4.00 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers15 claims17 services$65.65 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
5 suppliers12 claims12 services$26.11 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maridel Hernandez's NPI number?

The NPI number for Maridel Hernandez is 1023013711. It was assigned to this individual provider in the NPPES registry on June 17, 2005. The provider is also known as Maridel Aileen Hernandez D.O..

Where is Maridel Hernandez located?

Maridel Hernandez practices at 19603 E 8 Mile Rd, Saint Clair Shores, MI 48080. The listed phone number is (586) 445-7900.

What is Maridel Hernandez's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Maridel Hernandez enrolled in Medicare?

Yes. Maridel Hernandez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Maridel Hernandez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maridel Hernandez reassigns Medicare benefits to Maridel Hernandez Internal Medicine PC (Grosse Pointe Farms, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maridel Hernandez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maridel Hernandez accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and UnitedHealthcare list Maridel Hernandez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Maridel Hernandez affiliated with any hospitals?

According to CMS data, Maridel Hernandez is affiliated with Henry Ford Macomb Hospital, Henry Ford Health Hospital, Beaumont Hospital - Grosse Pointe, Ascension St John Hospital and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Maridel Hernandez was last updated on October 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.