JONATHAN ROBERT HERNANDEZ (DO) – Family Medicine Physician, NPI 1043951718

JONATHAN ROBERT HERNANDEZ (DO) is a healthcare provider. based in Watervliet, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 5101028436 (MI). The NPI Number for JONATHAN ROBERT HERNANDEZ (DO) is 1043951718

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN ROBERT HERNANDEZ (DO)
NPI
1043951718
Phone
(269) 463-3600
Address
400 Medical Park Dr Ste 200
Enumeration Date
5 April 2022
Last Update Date
4 June 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2694633600
Graduation Year
2022 (4 years ago)
PAC ID
3476999079
Group Practice PAC ID
7416942750
Professional Enrollment ID
I20250625000745
Address ID
MI490989225WA400XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for JONATHAN ROBERT HERNANDEZ (DO)

  • 400 Medical Park Dr Ste 200

    Watervliet, MI 490989225

    Phone: (269) 463-3600

    Type: Location

  • 2002 S 11th St

    Niles, MI 491204074

    Phone: (269) 687-0200

    Type: Location

  • 5515 Cleveland Ave Ste 5

    Stevensville, MI 491279669

    Phone: (269) 429-9644

    Type: Location

  • 1335 PINE HILL CT

    SAINT JOSEPH, MI 490852830

    Phone: (269) 207-2082

    Type: Mailing

  • 1234 NAPIER AVE

    SAINT JOSEPH, MI 490852112

    Phone: (269) 982-4941

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $193.

Total Amount is formed as General ($193) + Research ($0) + Ownership ($0) = $193.

Last reported payment date: 2024-10-05 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($40).

Total Amount

$193

General + Research + Ownership

Payments

10

Total payment records

General Amount

$193

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250625000745IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49098)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416942750View full group profile
NameSpecialtyState
-MI
Clinical PsychologistPA
Internal MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
Physician AssistantMI
Family PracticeMI
Nurse PractitionerMI
Nurse PractitionerMI
Orthopedic SurgeryMI

Reviews

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Frequently asked questions

How do I look up JONATHAN ROBERT HERNANDEZ (DO) by NPI?
Use NPI 1043951718 when you need to reference JONATHAN ROBERT HERNANDEZ (DO) in forms, claims, or directories.
Does this profile mean JONATHAN ROBERT HERNANDEZ (DO) is currently active?
Yes — JONATHAN ROBERT HERNANDEZ (DO) appears active in the national provider directory.
Can you summarize JONATHAN ROBERT HERNANDEZ (DO)'s specialty in plain language?
Clinically, the directory lists JONATHAN ROBERT HERNANDEZ (DO) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does JONATHAN ROBERT HERNANDEZ (DO) practice in Michigan?
You will see Watervliet, Michigan on file for JONATHAN ROBERT HERNANDEZ (DO) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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