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DR. LUIS OSCAR HERNANDEZ III M.D.
NPI 1205078649
Colon & Rectal Surgery in Miami, FL

Active since March 31, 2009PECOS EnrolledAccepts Medicare Assignment
82.63/100
CMS Quality Rating
7765 SW 87TH AVENUE, 212, MIAMI, FL 33173(305) 596-3080(305) 596-3073 Get Directions Write a Review

NPPES record last updated: August 7, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 7, 2020, Aug 8, 2017 (2 updates tracked since 2017).

About Dr. Luis Oscar Hernandez Iii M.d. NPPES

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

DR. LUIS OSCAR HERNANDEZ III M.D. (NPI 1205078649) is an individual colon & rectal surgery provider in Miami, Florida, licensed in Florida (ME124589) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS, is affiliated with Baptist Hospital Of Miami, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1205078649
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameDR. LUIS OSCAR HERNANDEZ IIICredential: M.D.
Location Address7765 SW 87TH AVENUE, 212Miami, FL 33173
Mailing Address9500 S Dadeland Blvd, 200Miami, FL 33156 · (305) 468-4185 · Fax (305) 596-3073
Phone(305) 596-3080
Fax(305) 596-3073
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateMarch 31, 2009
Last NPPES UpdateAugust 7, 20202 updates tracked since enumeration
NPPES CertifiedAugust 7, 2020
✔ NPI 1205078649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in FL · ME124589
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Also ListedSurgeryTaxonomy 208600000X · License TRN 13872 (FL)
7765 SW 87TH AVENUE, Miami, FL 33173
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Luis Oscar Hernandez Iii M.d. 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 ID547561870
PECOS Enrollment IDI20170811001316
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.

Areas of Expertise CMS Part B claims 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
68 services37 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
46 services29 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
43 services43 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.
41 services33 patients
Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
18 services12 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Baptist Hospital Of Miami

Acute Care Hospitals · Miami, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100008
Location8900 N Kendall DrMiami, FL 33176 · Miami-Dade County
Emergency services Birthing friendly

South Miami Hospital

Acute Care Hospitals · South Miami, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100154
Location6200 SW 73rd StSouth Miami, FL 33143 · Miami-Dade County
Emergency services Birthing friendly

West Kendall Baptist Hospital

Acute Care Hospitals · Miami, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100314
Location9555 SW 162 AveMiami, FL 33196 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33173 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
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$75.86 typical visit price
range $18.99 – $150.24
Typical copayment $18.96 (range $4.74 – $37.56)
Most-billed visit code 99213
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.

82.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.96
Promoting Interoperability100
Improvement Activities40
Cost67.14

Referred Medical Equipment & Supplies CMS DME claims 8

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

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
2 suppliers22 claims460 services$4.92 avg. paid by Medicare
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
3 suppliers15 claims252 services$2.30 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
3 suppliers22 claims480 services$8.47 avg. paid by Medicare
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each A4419
DME-Orthotic Devices · category DF010N
3 suppliers22 claims1,290 services$1.59 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
2 suppliers13 claims400 services$3.46 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
3 suppliers12 claims696 services$0.34 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 Luis Hernandez's NPI number?

The NPI number for Luis Hernandez is 1205078649. It was assigned to this individual provider in the NPPES registry on March 31, 2009.

Where is Luis Hernandez located?

Luis Hernandez practices at 7765 SW 87th Avenue 212, Miami, FL 33173. The listed phone number is (305) 596-3080.

What is Luis Hernandez's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Luis Hernandez enrolled in Medicare?

Yes. Luis 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.

What insurance does Luis Hernandez accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed and Oscar Health Maintenance Organization of Florida list Luis 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 Luis Hernandez affiliated with any hospitals?

According to CMS data, Luis Hernandez is affiliated with Baptist Hospital Of Miami, South Miami Hospital and West Kendall Baptist Hospital.

When was this NPI record last updated?

The NPPES record for Luis Hernandez was last updated on August 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.