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HERIBERTO FERNANDEZ MD
NPI 1598087520
Internal Medicine in Hialeah, FL

Active since February 17, 2010PECOS EnrolledAccepts Medicare AssignmentCLIA 10D2200694 · Waiver
777 E 25TH ST STE 509, HIALEAH, FL 33013(305) 420-5016(786) 452-9901 Get Directions Write a Review

NPPES record last updated: October 13, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 13, 2023, Feb 10, 2020 (2 updates tracked since 2020).

About Heriberto Fernandez Md NPPES

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

HERIBERTO FERNANDEZ MD (NPI 1598087520) is an individual internal medicine provider in Hialeah, Florida, licensed in Florida (ME 109800) and active in the NPI registry since February 2010. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through November 16, 2026, and is affiliated with Jackson Health System.

NPPES Registry Identity

NPI1598087520
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHERIBERTO FERNANDEZCredential: MD
Location Address777 E 25TH ST STE 509Hialeah, FL 33013-3834
Mailing Address777 E 25th St Ste 509Hialeah, FL 33013-3834 · (305) 420-5016 · Fax (786) 452-9901
Phone(305) 420-5016
Fax(786) 452-9901
Sole ProprietorYes
Medical School CMSOtherGraduated 1995
Enumeration DateFebruary 17, 2010
Last NPPES UpdateOctober 13, 20232 updates tracked since enumeration
NPPES CertifiedOctober 13, 2023
✔ NPI 1598087520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME 109800
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.
777 E 25TH ST STE 509, Hialeah, FL 33013
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Other Identifiers 1

Medicaid004351200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next 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

Heriberto Fernandez Md 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 ID143480020
PECOS Enrollment IDI20120330000230
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2200694

Heriberto Fernandez MD PA · Hialeah, FL
Active · expires Nov 16, 2026
CLIA Number10D2200694
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2024
Certificate Expiration DateNovember 16, 2026
Laboratory DirectorHeriberto Fernandez
Laboratory Phone(305) 420-5016
Laboratory LocationHeriberto Fernandez MD PA777 E 25th Street Unit 509, Hialeah, FL 33013
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
262 services20 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
202 services75 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
118 services110 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
90 services84 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
65 services60 patients
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.
53 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Steward Hialeah Hospital

Acute Care Hospitals · Hialeah, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100053
Location651 E 25th StHialeah, FL 33013 · Miami-Dade County
Emergency services

Steward Palmetto General Hospital

Acute Care Hospitals · Hialeah, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100187
Location2001 W 68th StHialeah, FL 33016 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33013 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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 4

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

MARIA OFELIA MIRABAL APRN
Nurse Practitioner (Psychiatric/Mental Health)
777 E 25TH ST STE 509
HIALEAH, FL 33013
Miami-Dade County (305) 420-5016
JOSE F BACA MD INC
Internal Medicine
777 E 25TH ST STE 509
HIALEAH, FL 33013
Miami-Dade County (305) 696-7557
PRO HOSPITAL GROUP, LLC
Internal Medicine
777 E 25TH ST STE 509
HIALEAH, FL 33013
Miami-Dade County (305) 420-5016
HERIBERTO FERNANDEZ MD PA
Internal Medicine
777 E 25TH ST STE 509
HIALEAH, FL 33013
Miami-Dade County (305) 420-5016

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 Heriberto Fernandez's NPI number?

The NPI number for Heriberto Fernandez is 1598087520. It was assigned to this individual provider in the NPPES registry on February 17, 2010.

Where is Heriberto Fernandez located?

Heriberto Fernandez practices at 777 E 25th St Ste 509, Hialeah, FL 33013. The listed phone number is (305) 420-5016.

What is Heriberto Fernandez's specialty?

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

Is Heriberto Fernandez enrolled in Medicare?

Yes. Heriberto Fernandez 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.

Does Heriberto Fernandez hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2200694) is associated with this NPI, valid through November 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Heriberto Fernandez accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, AvMed and Oscar Health Maintenance Organization of Florida and 1 other insurer list Heriberto Fernandez 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 Heriberto Fernandez affiliated with any hospitals?

According to CMS data, Heriberto Fernandez is affiliated with Jackson Health System, Steward Hialeah Hospital and Steward Palmetto General Hospital.

When was this NPI record last updated?

The NPPES record for Heriberto Fernandez was last updated on October 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.