DR. EDMOND DERDERIAN (M.D.) – Internal Medicine Physician, NPI 1114258944

DR. EDMOND DERDERIAN (M.D.) is a healthcare provider. based in Sherman oaks, California. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. A110089 (CA). The NPI Number for DR. EDMOND DERDERIAN (M.D.) is 1114258944

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. EDMOND DERDERIAN (M.D.)
NPI
1114258944
Phone
Not provided
Address
4955 VAN NUYS BLVD STE 308
Enumeration Date
18 January 2010
Last Update Date
24 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8183876114
Graduation Year
2001 (25 years ago)
PAC ID
2668651340
Group Practice PAC ID
4587109913
Professional Enrollment ID
I20110127000049
Address ID
CA914031811SH4955XBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

21,511 INTERNAL MEDICINE in CA

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Provider Addresses for DR. EDMOND DERDERIAN (M.D.)

  • Van Nuys Boulevard, Sherman Oaks, Los Angeles, Los Angeles County, California, 91423, United States

    SHERMAN OAKS, CA 914031811

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-04-09 • Largest payer in this snapshot: ACADIA Pharmaceuticals Inc ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110127000049IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes972280$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes879195$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes79659$0
99239Hospital discharge day management, more than 30 minutes209204$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes209200$0
View full utilization report →

Insurance plans in this area (ZIP 91403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587109913View full group profile
NameSpecialtyState
Nurse PractitionerCA
Internal MedicineCA
Family PracticeCA
Internal MedicineCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Where can patients find DR. EDMOND DERDERIAN (M.D.)'s NPI?
You can confirm DR. EDMOND DERDERIAN (M.D.) with NPI 1114258944; it appears in the national provider directory.
Is DR. EDMOND DERDERIAN (M.D.) active in the national directory?
DR. EDMOND DERDERIAN (M.D.)'s public NPI profile is in an active state.
What does DR. EDMOND DERDERIAN (M.D.) treat or focus on?
Patients typically see DR. EDMOND DERDERIAN (M.D.) under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. EDMOND DERDERIAN (M.D.) practice in California?
You will see Sherman Oaks, California on file for DR. EDMOND DERDERIAN (M.D.) alongside any extra practice locations.
What if Sherman Oaks, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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