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MS. KAREN THERESA HERNANDEZ PA-C
NPI 1427284413
Physician Assistant in Miami, FL

Active since June 03, 2009PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
1475 NW 12TH AVE, SUITE 3300, MIAMI, FL 33136(305) 243-9587(305) 243-9716 Get Directions Write a Review

NPPES record last updated: September 17, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Karen Theresa Hernandez Pa-c NPPES

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

MS. KAREN THERESA HERNANDEZ PA-C (NPI 1427284413) is an individual physician assistant in Miami, Florida, licensed in Florida (PA9104909) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS, is affiliated with Memorial Regional Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1427284413
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. KAREN THERESA HERNANDEZCredential: PA-C
Location Address1475 NW 12TH AVE, SUITE 3300Miami, FL 33136-1002
Mailing Address1475 Nw 12th Ave, Suite 3300Miami, FL 33136-1002 · (305) 243-9587 · Fax (305) 243-9716
Phone(305) 243-9587
Fax(305) 243-9716
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateJune 3, 2009
Last NPPES UpdateSeptember 17, 2010
✔ NPI 1427284413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9104909
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1475 NW 12TH AVE, Miami, FL 33136
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Oscar Health Maintenance Organization of Florida, UnitedHealthcare.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

Ms. Karen Theresa Hernandez Pa-c 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 ID2062600604
PECOS Enrollment IDI20101222000910
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 2

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 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.
125 services117 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.
52 services34 patients

Hospital Affiliations CMS Care Compare 2

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

Memorial Regional Hospital

Acute Care Hospitals · Hollywood, FL
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100038
Location3501 Johnson StHollywood, FL 33021 · Broward County
Emergency services Birthing friendly

Boca Raton Regional Hospital

Acute Care Hospitals · Boca Raton, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100168
Location800 Meadows RdBoca Raton, FL 33486 · Palm Beach County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

Reported Quality Measures

Breast Cancer Screening
63%116 patients3/55-star benchmark: 93%
Cervical Cancer Screening
13%129 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
13%185 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
75%40 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%344 patients5/55-star benchmark: 100%
e-Prescribing
98%164 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
98%125 patients4/55-star benchmark: 100%
HIV Screening
14%158 patients1/55-star benchmark: 60%
Oncology: Medical and Radiation - Pain Intensity Quantified
99%74 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
85%226 patients4/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
97%214 patients5/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
40%263 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 100% · 38 patients
100%38 patients
Provide Patients Electronic Access to Their Health Information
100%136 patients5/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 8% · 134 patients
Patients totalRate: 13% · 134 patients
8%134 patients4/55-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 3

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

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers52 claims2,716 services$0.67 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers35 claims35 services$17.37 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers25 claims26 services$11.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

MS. ALISSETTE NAVEDA ARNP
Nurse Practitioner (Family)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5360
WALTER G BRADLEY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1475 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33136
Miami-Dade County (305) 243-7520
DR. EVAN H SCHLAM MD
Dermatology
1475 NW 12TH AVE, BOX 016960
MIAMI, FL 33136
Miami-Dade County (305) 243-7688
DR. NESTOR RICARDO VILLAMIZAR M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-2363
MS. LINDSAY MARIE THORNTON MD
Radiology (Vascular & Interventional Radiology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5512
DR. GLENDA C HARRIS PH.D., L.AC.
Acupuncturist
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-1470
IVAYLO MIHAYLOV
Radiology (Radiation Oncology)
1475 NW 12TH AVE, SUITE 1500
MIAMI, FL 33136
Miami-Dade County (305) 243-8223
LOURDES MESTRE VALDES APRN
Nurse Practitioner (Gerontology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-4902

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 Karen Hernandez's NPI number?

The NPI number for Karen Hernandez is 1427284413. It was assigned to this individual provider in the NPPES registry on June 3, 2009.

Where is Karen Hernandez located?

Karen Hernandez practices at 1475 NW 12th Ave Suite 3300, Miami, FL 33136. The listed phone number is (305) 243-9587.

What is Karen Hernandez's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Karen Hernandez enrolled in Medicare?

Yes. Karen 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 Karen Hernandez accept?

Health plans from AmeriHealth Caritas Next, Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Karen 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 Karen Hernandez affiliated with any hospitals?

According to CMS data, Karen Hernandez is affiliated with Memorial Regional Hospital and Boca Raton Regional Hospital.

When was this NPI record last updated?

The NPPES record for Karen Hernandez was last updated on September 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.