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DERDERYAN MEDICAL GROUP INC.
NPI 1457712309
Internal Medicine in Sherman Oaks, CA

Active since March 18, 2016
4955 VAN NUYS BLVD STE 308, SHERMAN OAKS, CA 91403(646) 552-1547 Get Directions Write a Review

NPPES record last updated: February 7, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 7, 2021, Mar 18, 2016 (2 updates tracked since 2016).

About Derderyan Medical Group Inc. NPPES

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

DERDERYAN MEDICAL GROUP INC. (NPI 1457712309) is a healthcare organization registered as an internal medicine in Sherman Oaks, California and active in the NPI registry since March 2016. The organization lists Edmond Varuzhan Derderyan, President/owner, as its authorized official.

NPPES Registry Identity

NPI1457712309
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameDERDERYAN MEDICAL GROUP INC.
Location Address4955 VAN NUYS BLVD STE 308Sherman Oaks, CA 91403-1811
Mailing Address4955 Van Nuys Blvd Ste 308Sherman Oaks, CA 91403-1811
Phone(646) 552-1547
Organization SubpartNo
Authorized OfficialEdmond Varuzhan DerderyanPresident/owner · (646) 552-1547
Enumeration DateMarch 18, 2016
Last NPPES UpdateFebruary 7, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2021
✔ NPI 1457712309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4955 VAN NUYS BLVD STE 308, Sherman Oaks, CA 91403
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derderyan Medical Group Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Derderyan Medical Group Inc., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Edmond Derderian, M.D.
Internal Medicine
NPI 1114258944
4955 VAN NUYS BLVD STE 308
Sherman Oaks, CA 91403
(818) 528-1044
✔ PECOS✔ Accepts MedicareSame address
Keino Rutherford, MD
Internal Medicine
NPI 1497807853
4955 VAN NUYS BLVD STE 308
Sherman Oaks, CA 91403
✔ PECOS✔ Accepts MedicareSame address
Diana Akhverdyan, AGNP
Nurse Practitioner
NPI 1669178661
4955 VAN NUYS BLVD STE 308
Van Nuys, CA 91403
(818) 259-7070
✔ PECOS✔ Accepts MedicareSame address
Oleg Liakhovetski, M.D.
Internal Medicine
NPI 1154584316
4940 VAN NUYS BLVD STE 200
Sherman Oaks, CA 91403
(818) 528-1260
✔ PECOS✔ Accepts MedicareSame address
Hambartsoum Mekharian
Nurse Practitioner
NPI 1265095921
12635 ALBERS ST
Valley Village, CA 91607
(818) 618-2814
✔ PECOS✔ Accepts Medicare2.4 mi
James Conrad Contreras
Nurse Practitioner
NPI 1033586870
4619 ROSEWOOD AVE APT 106
Los Angeles, CA 90004
(646) 675-1650
✔ PECOS✔ Accepts Medicare10.0 mi
Cheryl Catalan
Nurse Practitioner
NPI 1275089641
4121 VIA MARINA APT 106
Marina Del Rey, CA 90292
(347) 703-3662
✔ PECOS✔ Accepts Medicare12 mi
Jason Wiguna, DO
Family Practice
NPI 1346731767
12601 GARDEN GROVE BLVD
Garden Grove, CA 92843
(714) 537-5160
✔ PECOS✔ Accepts Medicare41 mi
Desirae Mutuc, FNP-C
Nurse Practitioner
NPI 1215393384
23141 VERDUGO DR STE 201
Laguna Hills, CA 92653
(949) 215-5055
✔ PECOS✔ Accepts Medicare55 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Derderyan Medical Group Inc.'s NPI number?

The NPI number for Derderyan Medical Group Inc. is 1457712309. It was assigned to this organization in the NPPES registry on March 18, 2016.

Where is Derderyan Medical Group Inc. located?

Derderyan Medical Group Inc. is located at 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403. The listed phone number is (646) 552-1547.

What is Derderyan Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Derderyan Medical Group Inc. enrolled in Medicare?

Yes. Derderyan Medical Group Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Derderyan Medical Group Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Derderyan Medical Group Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Internal Medicine (3) and Family Practice (1). Of these, 4 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Derderyan Medical Group Inc. was last updated on February 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.