MEDICARE: DR. JON DAVID HERNANDEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD424128	PA
2	207XS0106X	Orthopaedic Hand Surgery Physician	MD424128	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00144458	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2170525	OTHER	MAMSI
3	2454072	OTHER	UNITED HEALTHCARE
4	90334	OTHER	GEISINGER HEALTH PLAN
6	P3253696	OTHER	OXFORD HEALTH PLANS
7	1614028	OTHER	HIGHMARK BLUE SHIELD
8	0651358	OTHER	CIGNA HEALTHCARE
9	2291153000	OTHER	INDEPENDENCE BLUE CROSS
10	2291153000	OTHER	AMERIHEALTH
11	328962	OTHER	HEALTH AMERICA/HEALTH ASS
12	50044348	OTHER	CAPITAL BLUE CROSS
13	50044348	OTHER	KEYSTONE HEALTH CENTRAL
14	819317	OTHER	FIRST PRIORITY HEALTH
15	9336898	OTHER	PRIVATE HEALTHCARE SYSTEM
16	2291153000	OTHER	KEYSTONE HEALTH EAST
17	556421	OTHER	AETNA PPO

General Provider Information

NPI Number	:	1871591198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON DAVID HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	2100 MACK BLVD FL 4
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-5622
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2226 BLAKESLEE BOULEVARD DR E STE 200
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-9619
Country	:	US
Telephone Number	:	610-408-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	10/12/2022

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