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DR. RAUL ALBERTO HERNANDEZ JR. M.D.
NPI 1588678684
Internal Medicine - Nephrology in Zanesville, OH

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
11.16/100
CMS Quality Rating
2809 BELL ST STE A, ZANESVILLE, OH 43701(740) 453-5003(740) 452-8826 Get Directions Write a Review

NPPES record last updated: May 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Raul Alberto Hernandez Jr. M.d. NPPES

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

DR. RAUL ALBERTO HERNANDEZ JR. M.D. (NPI 1588678684) is an individual nephrology provider in Zanesville, Ohio, licensed in Ohio (35060804) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Genesis Hospital, and is a graduate of Ohio State University College Of Medicine (1989).

NPPES Registry Identity

NPI1588678684
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. RAUL ALBERTO HERNANDEZ JR.Credential: M.D.
Location Address2809 BELL ST STE AZanesville, OH 43701-1741
Mailing Address2809 Bell St Ste AZanesville, OH 43701-1741 · (740) 453-5003 · Fax (740) 452-8826
Phone(740) 453-5003
Fax(740) 452-8826
Sole ProprietorYes
Medical School CMSOhio State University College Of MedicineGraduated 1989
Enumeration DateJuly 27, 2006
Last NPPES UpdateMay 27, 2021
NPPES CertifiedMay 27, 2021
✔ NPI 1588678684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in OH · 35060804
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedSpecialistTaxonomy 174400000X · License 35-06-0804-H (OH)
2809 BELL ST STE A, Zanesville, OH 43701
Open in Google Maps ↗

Other Identifiers 1

Medicaid0811992OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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. Raul Alberto Hernandez Jr. 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 ID3072534122
PECOS Enrollment IDI20090403000088
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 9

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.
442 services251 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.
402 services190 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.
142 services142 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
91 services14 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
85 services83 patients
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.
45 services37 patients

Hospital Affiliations CMS Care Compare

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

Genesis Hospital

Acute Care Hospitals · Zanesville, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360039
Location2951 Maple AvenueZanesville, OH 43701 · Muskingum County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43701 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

11.16/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost37.23

Referred Medical Equipment & Supplies CMS DME claims 14

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
14 suppliers67 claims174 services$6.21 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier12 claims12 services$9.38 avg. paid by Medicare
Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
2 suppliers14 claims72 services$5.52 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$4.76 avg. paid by Medicare
Ostomy pouch, urinary; for use on barrier with flange (2 piece), each A5073
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$2.97 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
2 suppliers15 claims750 services$0.21 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 2

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

MUSKINGUM MEDICAL GROUP, LTD.
Specialist
2809 BELL ST STE A
ZANESVILLE, OH 43701
Muskingum County (740) 453-5003
AMBER CLENDENNING
Nurse Practitioner (Family)
2809 BELL ST STE A
ZANESVILLE, OH 43701
Muskingum County (740) 453-5003

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 Raul Hernandez's NPI number?

The NPI number for Raul Hernandez is 1588678684. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Raul Hernandez located?

Raul Hernandez practices at 2809 Bell St Ste A, Zanesville, OH 43701. The listed phone number is (740) 453-5003.

What is Raul Hernandez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Raul Hernandez enrolled in Medicare?

Yes. Raul 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 Raul Hernandez accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual list Raul 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 Raul Hernandez affiliated with any hospitals?

According to CMS data, Raul Hernandez is affiliated with Genesis Hospital.

When was this NPI record last updated?

The NPPES record for Raul Hernandez was last updated on May 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.