Individual provider Active NPI

David Edward Fermelia, M D

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1932280450
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G57874 Issued in CA
Practice address
8631 W 3Rd St Ste 710E
Los Angeles, CA 90048-5911
Phone
(310) 278-0567
Fax
(310) 854-5672
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G57874 CA Primary

Addresses

Primary practice location

8631 W 3Rd St Ste 710E
Los Angeles, CA 90048-5911

Mailing address

8631 W 3Rd St Ste 710E
Los Angeles, CA 90048-5911
Phone (310) 278-0567

Other identifiers 1

IdentifierTypeStateIssuer
00G578740MedicaidCA

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
I20080423000753 CA Practitioner - General Surgery 6901984475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57874CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Feb 1, 2008 Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

8631 W 3rd St
Ste 710E
Los Angeles, CA 90048
Phone (310) 746-5335

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

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, 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932280450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 710E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485911",
            "telephone_number": "310-278-0567",
            "fax_number": "310-854-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 710E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485911",
            "telephone_number": "310-278-0567",
            "fax_number": "310-854-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERMELIA",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G57874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G578740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.