LISA JEANNE BOUMA HERNANDEZ MD
NPI 1336487784
Pediatrics in Orlando, FL

Q: What is Lisa Bouma Hernandez's NPI number?

The NPI number for Lisa Bouma Hernandez is 1336487784. It was assigned to this individual provider in the NPPES registry on January 18, 2013.

Q: What is Lisa Bouma Hernandez's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since January 18, 2013PECOS Enrolled

3464 AVALON PARK EAST BLVD, ORLANDO, FL 32828(407) 635-3020(321) 203-4607 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 2, 2025, Oct 8, 2024, Aug 17, 2023 (3 updates tracked since 2023).

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About Lisa Jeanne Bouma Hernandez Md NPPES

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

LISA JEANNE BOUMA HERNANDEZ MD (NPI 1336487784) is an individual pediatrics provider in Orlando, Florida, licensed in Florida (ME166907) and active in the NPI registry since January 2013. She is enrolled in Medicare PECOS and maintains a secondary practice location in Kissimmee.

NPPES Registry Identity

NPI1336487784

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameLISA JEANNE BOUMA HERNANDEZCredential: MD

Location Address3464 AVALON PARK EAST BLVDOrlando, FL 32828-7363

Mailing Address3464 Avalon Park East BlvdOrlando, FL 32828-7363 · (407) 635-3020 · Fax (321) 203-4607

Phone(407) 635-3020

Fax(321) 203-4607

Sole ProprietorYes

Enumeration DateJanuary 18, 2013

Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2025

✔ NPI 1336487784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in FL · ME166907✔ Licensed in NY · 276845

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

3464 AVALON PARK EAST BLVD, Orlando, FL 32828

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Secondary Practice Location 1

Location 13236 N Poinciana Blvd Ste 100Kissimmee, FL 34746-4688 · Phone (076) 355-9524 · Fax (407) 636-7802

Other Identifiers 1

Medicaid124579800FL

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Jeanne Bouma Hernandez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Lisa Bouma Hernandez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Orlando Physicians Network Inc

14 mi

Internal Medicine

21 W COLUMBIA ST
Orlando, FL 32806

Reassigned Medicare billing, Florida enrollment
339 clinicians in this Medicare group

NPI 1568693554 (407) 481-7174

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32828 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JENNIFER L DAVIS ARNP-C

Nurse Practitioner (Adult Health)