Individual provider Active NPI

Donald G Demaderios, MA, MFTI, LPCCI

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1558615252
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(310) 389-5230
Fax
(310) 398-5690
NPI assigned
Nov 1, 2012
Last updated
Feb 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

323 N Prairie Ave
Inglewood, CA 90301-4502
Phone (310) 677-7808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, CA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20251126001706 PA Practitioner - Marriage and Family Therapist 9739671736 Reassigns benefits to 1 organization
I20251126002251 NJ Practitioner - Marriage and Family Therapist 9739671736 Reassigns benefits to 1 organization
I20251210003294 CA Practitioner - Marriage and Family Therapist 9739671736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Nov 5, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Oct 28, 2025 Accepting new patients
Grow Healthcare Group of New Jersey PC Marriage & Family Therapist CurrentSince Oct 28, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

3753 Howard Hughes Pkwy
Ste 200
Las Vegas, NV 89169
Phone (702) 919-6580

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Interoperability endpoints

  • Direct secure messaging: donalddemaderios@tdh.allscriptsdirect.net

Organizations & group practices 4

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": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1558615252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-677-7808",
            "fax_number": "310-846-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-389-5230",
            "fax_number": "310-398-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMADERIOS",
        "first_name": "DONALD",
        "middle_name": "G",
        "credential": "MA, MFTI, LPCCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-01",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.