Individual provider Active NPI

Elise Herro, M.D.

  • Dermatology Physician
  • Sherman Oaks, CA
National Provider Identifier
1104053743
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
114480 Issued in CA
Practice address
4836 Van Nuys Blvd
Sherman Oaks, CA 91403-2101
Phone
(818) 907-7546
NPI assigned
Jun 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 114480 CA Primary

Addresses

Primary practice location

4836 Van Nuys Blvd
Sherman Oaks, CA 91403-2101

Mailing address

4836 Van Nuys Blvd
Sherman Oaks, CA 91403-2101
Phone (818) 907-7546

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813011268 CA Practitioner - DermatologyPractitioner - Family Practice 3577720077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Arkansas College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Skin Institute IncGroup PAC ID 8224285085, 8 clinicians

Practice addresses (Care Compare)

1240 S Westlake Blvd
Suite 217
Westlake Village, CA 91361-1995
Phone (805) 497-0097

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions471
Removal or shaving of skin growth1-10
Skin biopsy73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
American Skin Institute Inc. Dermatology CurrentSince Feb 8, 2016 Accepting new patients
Asi Surgery Center, Inc. Past Accepting new patients
Clinica Familiar Mexicana I LLC Past Accepting new patients

Locations

4836 Van Nuys Blvd
Sherman Oaks, CA 91403
Phone (818) 907-7546

1240 S Westlake Blvd
Ste 217
Westlake Vlg, CA 91361
Phone (805) 497-0097

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1104053743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4836 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032101",
            "telephone_number": "818-907-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4836 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032101",
            "telephone_number": "818-907-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRO",
        "first_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-21",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "114480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.