Individual provider Active NPI

Samuel Zemede, DPT

  • Physical Therapist
  • West Hollywood, CA
National Provider Identifier
1366047011
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299221 Issued in CA
Practice address
8354 Santa Monica Blvd
West Hollywood, CA 90069-4313
Phone
(323) 831-2455
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299221 CA Primary

Addresses

Primary practice location

8354 Santa Monica Blvd
West Hollywood, CA 90069-4313

Mailing address

5618 1/2 Bakman Ave
North Hollywood, CA 91601-1721
Phone (559) 289-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
299221CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myodetox California PC Inc. CurrentSince Apr 23, 2023 Accepting new patients

Locations

8354 Santa Monica Blvd
West Hollywood, CA 90069
Phone (323) 831-2455

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1366047011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 1/2 BAKMAN AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916011721",
            "telephone_number": "559-289-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8354 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694313",
            "telephone_number": "323-831-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMEDE",
        "first_name": "SAMUEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.