Individual provider Active NPI

David Jon Herman II, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1205254331
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A140451 Issued in CA
Practice address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone
(323) 993-7500
NPI assigned
Apr 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A140451 CA Primary

Addresses

Primary practice location

1625 Schrader Blvd
Los Angeles, CA 90028-6213

Mailing address

8633 W Knoll Dr Apt 202
West Hollywood, CA 90069-4133
Phone (914) 924-0819

Other practice location 1

1200 N State St
CT-A7D
Los Angeles, CA 90033-1029
Phone (323) 226-7556

Other identifiers 1

IdentifierTypeStateIssuer
DH3232267556MedicaidCA

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
I20200320001730 CA Practitioner - Internal Medicine 2163787110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles LGBT CenterGroup PAC ID 8729975453, 29 clinicians

Practice addresses (Care Compare)

1625 Schrader Blvd
FL 3
Los Angeles, CA 90028-6213
Phone (323) 993-7400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center Multi-Specialty CurrentSince Feb 2, 2020 Accepting new patients
Los Angeles LGBT Center CurrentSince Feb 2, 2020 Accepting new patients

Locations

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008
Phone (323) 860-3799

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1205254331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8633 W KNOLL DR APT 202",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694133",
            "telephone_number": "914-924-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "CT-A7D",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-226-7556",
            "fax_number": "323-226-2657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "DAVID",
        "middle_name": "JON",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-05",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A140451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DH3232267556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.