Individual provider Active NPI

Derek Joseph Fiedler

  • Certified Registered Nurse Anesthetist
  • Orange, CA
National Provider Identifier
1205391620
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95001930 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8888
NPI assigned
Feb 11, 2019
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95001930 CA Primary
Anesthesiology Physician 207L00000X 209018750 IL

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-8888

Other practice location 1

University of Chicago
5841 S Maryland Ave
Chicago, IL 60637
Phone (773) 702-1234

Other practice location 2

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other practice location 3

700 W El Norte Pkwy
Escondido, CA 92026-3923
Phone (760) 738-7830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230206001579 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890170195 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brotman Medical Anesthesia GroupGroup PAC ID 8123027547, 9 clinicians
San Gabriel Anesthesia Associates, PCGroup PAC ID 3678720604, 16 clinicians

Practice addresses (Care Compare)

16501 Ventura Blvd
Suite 103
Encino, CA 91436-2064
Phone (818) 907-1080

44139 Monterey Ave
Suite B
Palm Desert, CA 92260-8700
Phone (760) 779-5599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Anesthesiology CurrentSince Sep 16, 2024 Accepting new patients
Regents of the University of California CurrentSince Dec 25, 2022 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Feb 1, 2024 Accepting new patients
Regents of the Univ of Ca Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
Brotman Medical Anesthesia Group Anesthesiology CurrentSince Mar 1, 2025 Accepting new patients
Regents of the University of California Nurse Anesthetist, Certified Registered CurrentSince Dec 25, 2022 Accepting new patients
Morpheus Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Escondido Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2023 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

8641 Wilshire Blvd
Ste 201
Beverly Hills, CA 90211
Phone (310) 289-8600

16501 Ventura Blvd
Ste 103
Encino, CA 91436
Phone (310) 659-6333

488 E Valley Pkwy
Ste 110
Escondido, CA 92025
Phone (760) 735-6290

8741 Alden Dr
Ste B
Los Angeles, CA 90048
Phone (951) 556-2665

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

3410 La Sierra Ave
Ste F510
Riverside, CA 92503
Phone (909) 227-5139

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

18226 Ventura Blvd
Ste 102
Tarzana, CA 91356
Phone (818) 905-5904

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1205391620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Chicago",
            "address_2": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60637",
            "country_code": "US",
            "telephone_number": "773-702-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 W El Norte Pkwy",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920263923",
            "country_code": "US",
            "telephone_number": "760-738-7830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIEDLER",
        "first_name": "DEREK",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-11",
        "last_updated": "2026-09-29",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001930",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "209018750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.