Tanya Kormeili, MD, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A83828 Issued in CA

Legal business name

TANYA KORMEILI, MD, PC

Doing business as

Derm & Rejuvenation Institute

Practice address

2811 Wilshire Blvd
Suite 640
Santa Monica, CA 90403

Phone

(310) 526-8301

NPI assigned

Jun 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tanya Kormeili, M.DNPI 1245450766

Title

Ceo

Phone

(310) 526-8301

Specialties & licenses 1

Addresses

Other names 3

• Derm & Rejuvenation Institute Doing business as
• Tanya Kormeili MD PC Other name
• Tanya Kormeili, MD, APC Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00293

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanya Kormeili, MD

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1245450766
  Medicare reassignment Care Compare group NPD Authorized official
• Hootan Zandifar, MD

  • Facial Plastic Surgery Physician
  • Beverly Hills, CA
  • NPI 1679747307
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1477758159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 640",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-526-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 640",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-526-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA KORMEILI, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "KORMEILI",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-526-8301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A83828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derm & Rejuvenation Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Derm & Rejuvenation Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tanya Kormeili MD PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tanya Kormeili, MD, APC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mikiko Tanabe
• Tandem Genetics
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• Stephen Tang, M.D.
• Jeffrey Michael Tanner, D.D.S.
• Tao of Medicine Inc. (Tao of Medicine)
• Amanda Marie Tapia
• Alexandra Tappan, MFT
• Carla V. Tardio, M.D.
• Milton Mitsuyoshi Tari, O.D.

• Dermatology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.