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DR. MARC E FERNANDEZ M.D.
NPI 1972571727
Surgery in Hernando, FL

Active since March 09, 2006PECOS EnrolledAccepts Medicare Assignment
77.02/100
CMS Quality Rating
2456 N ESSEX AVE, HERNANDO, FL 34442(352) 513-4783(352) 513-4810 Get Directions Write a Review

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

Record update history: Feb 5, 2025, Oct 17, 2023, Dec 6, 2022 and 4 more (7 updates tracked since 2016).

About Dr. Marc E Fernandez M.d. NPPES

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

DR. MARC E FERNANDEZ M.D. (NPI 1972571727) is an individual surgery provider in Hernando, Florida, licensed in North Carolina (39262) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1972571727
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. MARC E FERNANDEZCredential: M.D.
Location Address2456 N ESSEX AVEHernando, FL 34442-5321
Mailing Address2456 N Essex AveHernando, FL 34442-5321 · (352) 513-4783 · Fax (352) 513-4810
Phone(352) 513-4783
Fax(352) 513-4810
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateMarch 9, 2006
Last NPPES UpdateApril 25, 20257 updates tracked since enumeration
NPPES CertifiedApril 25, 2025
✔ NPI 1972571727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in NC · 39262✔ Licensed in FL · ME68189
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
2456 N ESSEX AVE, Hernando, FL 34442
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Secondary Practice Locations 3

Location 12400 N Essex AveHernando, FL 34442-5320 · Phone (352) 513-4276 · Fax (352) 513-5843
Location 22209 S Sterling St Ste 530Morganton, NC 28655-4093 · Phone (828) 580-2250
Location 3204 Airport RdKinston, NC 28504-8814 · Phone (252) 775-5999 · Fax (252) 208-1647

Other Identifiers 2

Medicaid010727700FL
Other1972571727FL · Npi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Maintenance Organization of Florida, Sanford Health Plan 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 and accepts Medicare assignment

Dr. Marc E Fernandez 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 ID9638137839
PECOS Enrollment IDI20231027001944, I20240613000805
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 Reassignments

4

Medicare enrollment records show Marc Fernandez reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Unc Physicians Network, LLC
468 mi
Cardiovascular Disease
205 PAGE RD
Pinehurst, NC 28374
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,337 clinicians in this Medicare group
NPI 1396174363 (910) 295-5511
Vidant Medical Group LLC
524 mi
Ambulatory Surgical
701 DOCTORS DR STE N
Kinston, NC 28501
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,653 clinicians in this Medicare group
NPI 1376049619 (252) 559-2200
Windom Area Hospital
1,215 mi
Clinic/Center
717 S STATE ST STE 800
Fairmont, MN 56031
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1831187509 (Minnesota), NPI 1841288644 (Minnesota)
  • 39 clinicians in this Medicare group
NPI 1790621894 (507) 831-2500
Centracare Clinic Southwest LLC
1,314 mi
Multi-Specialty
101 WILLMAR AVE SW
Willmar, MN 56201
  • Reassigned Medicare billing, Minnesota enrollment
  • 236 clinicians in this Medicare group
NPI 1174106264 (320) 231-5000

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 34442 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
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

77.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.9
Promoting Interoperability98
Improvement Activities40
Cost22.35

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
74%189 patients4/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
24%126 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
72%362 patients4/55-star benchmark: 85%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
91%68 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
91%400 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
48%305 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%558 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
82%771 patients4/55-star benchmark: 97%
Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin
Percentage of surgical patients aged 18 years and older undergoing procedures with the indications for a first OR second generation cephalosporin prophylactic antibiotic, who had an order for a first OR second generation cephalosporin for antimicrobial…
100%42 patients
Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
Percentage of surgical patients aged 18 years and older undergoing procedures for which venous thromboembolism (VTE) prophylaxis is indicated in all patients, who had an order for Low Molecular Weight Heparin (LMWH), Low- Dose Unfractionated Heparin (LDUH)…
100%40 patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
80%668 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
72%207 patients4/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
15%651 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 404 patients
Patients tobacco: 95% · 404 patients
84%63 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%771 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
43%771 patients2/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 383 patients
0%383 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
17%771 patients
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.

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.

BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC
Surgery
2456 N ESSEX AVE
HERNANDO, FL 34442
Citrus County (352) 513-4783
TAMPA GENERAL MEDICAL GROUP INC
Surgery
2456 N ESSEX AVE
HERNANDO, FL 34442
Citrus County (352) 513-4783
CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC
Surgery
2456 N ESSEX AVE
HERNANDO, FL 34442
Citrus County (352) 513-4783
BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC
Internal Medicine
2456 N ESSEX AVE
HERNANDO, FL 34442
Citrus County (352) 513-4783

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 Marc Fernandez's NPI number?

The NPI number for Marc Fernandez is 1972571727. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Where is Marc Fernandez located?

Marc Fernandez practices at 2456 N Essex Ave, Hernando, FL 34442. The listed phone number is (352) 513-4783.

What is Marc Fernandez's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Marc Fernandez enrolled in Medicare?

Yes. Marc 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.

Which organizations bill Medicare for Marc Fernandez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marc Fernandez reassigns Medicare benefits to 4 organizations: Unc Physicians Network, LLC (Pinehurst, NC), Vidant Medical Group LLC (Kinston, NC), Windom Area Hospital (Fairmont, MN) and Centracare Clinic Southwest LLC (Willmar, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marc Fernandez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marc Fernandez accept?

Health plans from Blue Cross and Blue Shield of NC, Oscar Health Maintenance Organization of Florida, Sanford Health Plan and UnitedHealthcare list Marc 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.

When was this NPI record last updated?

The NPPES record for Marc Fernandez was last updated on April 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.