Individual provider Active NPI

David Joseph Hermiz, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1316382849
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A133957 Issued in CA
Practice address
3415 S Sepulveda Blvd Ste 1100
Los Angeles, CA 90034-7090
Phone
(424) 348-4558
Fax
(424) 377-6076
NPI assigned
May 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A133957 CA
Psychiatry Physician 2084P0800X A133957 CA Primary

Addresses

Primary practice location

3415 S Sepulveda Blvd Ste 1100
Los Angeles, CA 90034-7090

Mailing address

3415 S Sepulveda Blvd Ste 1100
Los Angeles, CA 90034-7090
Phone (424) 348-4558

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
I20170707002567 CA Practitioner - Psychiatry 0345527073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3415 S Sepulveda Blvd
Suite 1100
Los Angeles, CA 90034-7090
Phone (424) 348-4558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133957CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
David J Hermiz MD Psychiatry CurrentSince Jun 12, 2020 Accepting new patients

Locations

3415 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90034
Phone (424) 348-4558

Organizations & group practices 1

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1316382849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 S SEPULVEDA BLVD STE 1100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900347090",
            "telephone_number": "424-348-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S SEPULVEDA BLVD STE 1100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900347090",
            "telephone_number": "424-348-4558",
            "fax_number": "424-377-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMIZ",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A133957",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A133957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.