Active NPI
Benjamin Van Der Woerd, MD
- Otolaryngology Physician
- Los Angeles, CA
National Provider Identifier
1538759899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 171313
- Practice address
- 1450 San Pablo St Ste 5100
Los Angeles, CA 90033-5331 - Phone
- (323) 409-7316
- NPI assigned
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 171313 | CA | Primary |
Addresses
Primary practice location
1450 San Pablo St Ste 5100
Los Angeles, CA 90033-5331
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | benjamin.vanderwoerd@direct.usc.edu | Direct | USC CARE MEDICAL GROUP, INC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171313 | CA | MD | Otolaryngology Physician |
Interoperability endpoints
- benjamin.vanderwoerd@direct.usc.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1538759899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-442-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 SAN PABLO ST STE 5100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335331",
"telephone_number": "323-409-7316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DER WOERD",
"first_name": "BENJAMIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "171313",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "benjamin.vanderwoerd@direct.usc.edu",
"affiliation": "Y",
"endpointDescription": "benjamin.vanderwoerd@direct.usc.edu",
"affiliationName": "USC CARE MEDICAL GROUP, INC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1450 San Pablo St Ste 5100",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900335331",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.