Active NPI
Isaac Henry Derman
- Student in an Organized Health Care Education/Training Program
- Los Angeles, CA
National Provider Identifier
1144023268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029 - Phone
- (541) 706-1849
- NPI assigned
- Apr 1, 2025
- Last updated
- Apr 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029
Mailing address
1200 N. State Street, GNH 1060K
Los Angeles, CA 90033
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250814002412 | CA | Order and Referring Only - Emergency Medicine | 7113426594 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N/A | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1144023268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N. STATE STREET, GNH 1060K",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "CLINIC TOWER, SUITE A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "541-706-1849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERMAN",
"first_name": "ISAAC",
"middle_name": "HENRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-01",
"last_updated": "2025-04-01",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.