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DR. AUNDREE HERMAWAN MD
NPI 1295343523
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since July 22, 2020PECOS Enrolled
1200 N STATE ST RM C4E100, LOS ANGELES, CA 90089(323) 442-7400 Get Directions Write a Review

NPPES record last updated: May 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2024, Jul 22, 2020 (2 updates tracked since 2020).

About Dr. Aundree Hermawan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AUNDREE HERMAWAN MD (NPI 1295343523) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Dallas.

NPPES Registry Identity

NPI1295343523
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. AUNDREE HERMAWANCredential: MD
Location Address1200 N STATE ST RM C4E100Los Angeles, CA 90089-1001
Mailing Address1200 N State St Rm C4e100Los Angeles, CA 90089-1001 · (323) 442-7400
Phone(323) 442-7400
Sole ProprietorNo
Enumeration DateJuly 22, 2020
Last NPPES UpdateMay 6, 20242 updates tracked since enumeration
NPPES CertifiedMay 6, 2024
✔ NPI 1295343523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1200 N STATE ST RM C4E100, Los Angeles, CA 90089
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Secondary Practice Location 1

Location 15323 Harry Hines BlvdDallas, TX 75390-9006 · Phone (214) 648-2168 · Fax (214) 648-7517

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Aundree Hermawan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JORDAN ISAIAH JONES MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 865-1084
DR. HARRISON JOSEPH MA MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (626) 348-7639
DR. WILLIAM NARINYAN DO
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (818) 802-0702
KENNETH SCHMITT
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 442-7400
JERED ROBERT DAVIDSON
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 865-1084
GAUTHAM PAVAR
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 865-1084
JORENA LIM
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 442-7400
DR. SAUMYA SHAH DO
Student in an Organized Health Care Education/Training Program
1200 N STATE ST RM C4E100
LOS ANGELES, CA 90089
Los Angeles County (323) 865-1084

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aundree Hermawan's NPI number?

The NPI number for Aundree Hermawan is 1295343523. It was assigned to this individual provider in the NPPES registry on July 22, 2020.

Where is Aundree Hermawan located?

Aundree Hermawan practices at 1200 N State St Rm C4e100, Los Angeles, CA 90089. The listed phone number is (323) 442-7400.

What is Aundree Hermawan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Aundree Hermawan enrolled in Medicare?

Yes. Aundree Hermawan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Aundree Hermawan was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.