Individual provider Active NPI

Dru Imrie, M.D./PH.D.

  • Pediatrics Physician
  • Hemet, CA
National Provider Identifier
1861853236
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A148882 Issued in CA
Practice address
1285 S State St
Hemet, CA 92543-7976
Phone
(951) 765-1777
Fax
(951) 765-1772
NPI assigned
Mar 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X A148882 CA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A148882 CA Primary

Addresses

Primary practice location

1285 S State St
Hemet, CA 92543-7976

Mailing address

1285 S State St
Hemet, CA 92543-7976
Phone (951) 765-1777

Other practice location 1

1975 4th St
San Francisco, CA 94143-2351
Phone (415) 476-1000

Other practice location 2

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (833) 574-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20210901003510 CA Practitioner - Pediatric Medicine 6901175983 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A148882CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jun 28, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 5, 2021 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 28, 2021 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jun 28, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 28, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 28, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
University of California San Francisco Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 11

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": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1861853236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437976",
            "telephone_number": "951-765-1777",
            "fax_number": "951-765-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437976",
            "telephone_number": "951-765-1777",
            "fax_number": "951-765-1772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1975 4th St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432351",
            "country_code": "US",
            "telephone_number": "415-476-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10800 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053043",
            "country_code": "US",
            "telephone_number": "833-574-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMRIE",
        "first_name": "DRU",
        "credential": "M.D./PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-14",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A148882",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A148882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.