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THOMAS HERNANDEZ M.D.
NPI 1851513089
Orthopaedic Surgery in Dixon, IL

Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
82.13/100
CMS Quality Rating
215 E 1ST ST STE 326, DIXON, IL 61021(815) 285-5800(815) 285-5691 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2024, Aug 23, 2018 (2 updates tracked since 2018).

About Thomas Hernandez M.d. NPPES

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

THOMAS HERNANDEZ M.D. (NPI 1851513089) is an individual orthopaedic surgery provider in Dixon, Illinois, licensed in Illinois (036-129768) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and maintains a secondary practice location in Augusta.

NPPES Registry Identity

NPI1851513089
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameTHOMAS HERNANDEZCredential: M.D.
Location Address215 E 1ST ST STE 326Dixon, IL 61021-3190
Mailing Address337 Old Salem WayMartinez, GA 30907-9081 · (706) 210-1825
Phone(815) 285-5800
Fax(815) 285-5691
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2003
Enumeration DateMay 3, 2007
Last NPPES UpdateNovember 20, 20242 updates tracked since enumeration
NPPES CertifiedNovember 20, 2024
✔ NPI 1851513089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in IL · 036-129768
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Pediatric Orthopaedic SurgeryTaxonomy 207XP3100X · License BM6733807-R49 (GA)
Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License 036-129768 (IL)
215 E 1ST ST STE 326, Dixon, IL 61021
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Other Names 1

Other Name (5)Dr. Tommy Hernandez M.d.

Secondary Practice Location 1

Location 11120 15th St, Dept of OrthopaedicsAugusta, GA 30912-0004 · Phone (706) 721-1801

Other Identifiers 3

Other381220030IL · Medicare
OtherBM6733807-R49GA · Temp Residency Training #
Medicaid036129768IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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

Thomas Hernandez 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 ID7618124975
PECOS Enrollment IDI20120822000340
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.
313 services210 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
290 services151 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
64 services58 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.
45 services45 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
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.
28 services28 patients

Hospital Affiliations CMS Care Compare

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

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140012
Location403 E 1st StDixon, IL 61021 · Lee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61021 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

82.13/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.8
Promoting Interoperability98
Improvement Activities40
Cost66.07

Referred Medical Equipment & Supplies CMS DME claims

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

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier12 claims12 services$28.52 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 Thomas Hernandez's NPI number?

The NPI number for Thomas Hernandez is 1851513089. It was assigned to this individual provider in the NPPES registry on May 3, 2007. The provider is also known as Dr. Tommy Hernandez M.D..

Where is Thomas Hernandez located?

Thomas Hernandez practices at 215 E 1st St Ste 326, Dixon, IL 61021. The listed phone number is (815) 285-5800.

What is Thomas Hernandez's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Thomas Hernandez enrolled in Medicare?

Yes. Thomas 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 Thomas Hernandez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and Quartz list Thomas 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 Thomas Hernandez affiliated with any hospitals?

According to CMS data, Thomas Hernandez is affiliated with Katherine Shaw Bethea Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Hernandez was last updated on November 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.