Active NPI
Shane Alan Hervey, MD
- Family Medicine Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A191828
- Practice address
- 1225 15TH St Ste 2100
Santa Monica, CA 90404-1101 - Phone
- (310) 319-1234
- NPI assigned
- Apr 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A191828 | CA | Primary |
Addresses
Primary practice location
1225 15TH St Ste 2100
Santa Monica, CA 90404-1101
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
1001 Potrero Ave Bldg 80-83
San Francisco, CA 94110-3518
Phone (628) 206-5252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Medical Plaza
Suite 170
Los Angeles, CA 90095-0001
Phone (310) 319-1234
1250 16TH St
Santa Monica, CA 90404-1249
403 W Adams Blvd
Los Angeles, CA 90007-2664
Phone (213) 742-1162
Hospital & facility affiliations
- Ronald Reagan UCLA Medical Center
- Santa Monica - UCLA Med Ctr & Orthopaedic Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A191828 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| UCLA Medical Group | Family Medicine | Past | Accepting new patients |
Locations
100 UCLA Medical Plz
Ste 170
Los Angeles, CA 90024
Phone (858) 534-3880
File 54206
Los Angeles, CA 90074
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
1111 W Inyokern Rd
Ste B
Ridgecrest, CA 93555
Phone (760) 301-6945
1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695
1225 15th St
Ste 2100
Santa Monica, CA 90404
Phone (424) 259-6560
1131 Wilshire Blvd
Ste 100
Santa Monica, CA 90401
Phone (310) 458-2381
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Los Angeles, CA
- NPI 1528179793
-
- Durable Medical Equipment & Medical Supplies
- West Hills, CA
- NPI 1144112699
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1427055839
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1902803315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754006400000",
"number": "1043899784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 15TH ST STE 2100",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041101",
"telephone_number": "310-319-1234"
}
],
"practiceLocations": [
{
"address_1": "1001 Potrero Ave Bldg 80-83",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941103518",
"country_code": "US",
"telephone_number": "628-206-5252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERVEY",
"first_name": "SHANE",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-07",
"last_updated": "2025-08-01",
"certification_date": "2025-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A191828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.