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AXODERM CORP
NPI 1891675674
Emergency Medicine - Medical Toxicology in Glendale, CA

Active since September 03, 2025
1510 S CENTRAL AVE STE 640, GLENDALE, CA 91204(310) 933-5054(310) 935-3367 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Axoderm Corp NPPES

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

AXODERM CORP (NPI 1891675674) is a healthcare organization registered as a medical toxicology in Glendale, California and active in the NPI registry since September 2025. The organization lists Angie Davoody, Office Manager / Executive, as its authorized official.

NPPES Registry Identity

NPI1891675674
Entity TypeOrganization
Primary Taxonomy207PT0002X
Legal Business NameAXODERM CORP
Location Address1510 S CENTRAL AVE STE 640Glendale, CA 91204-2552
Mailing Address1510 S Central Ave Ste 640Glendale, CA 91204-2552 · (310) 933-5054 · Fax (310) 935-3367
Phone(310) 933-5054
Fax(310) 935-3367
Organization SubpartNo
Authorized OfficialAngie DavoodyOffice Manager / Executive · (818) 242-3200
Enumeration DateSeptember 3, 2025
NPPES CertifiedSeptember 3, 2025
✔ NPI 1891675674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Medical ToxicologyAllopathic & Osteopathic Physicians
Taxonomy Code207PT0002X
Definition
Medical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to drugs and chemicals, as well as biological and radiological agents. Medical toxicologists care for people in clinical, academic, governmental and public health settings, and provide poison control center leadership. Important areas of medical toxicology include acute drug poisoning, adverse drug events, drug abuse, addiction and withdrawal, chemicals and hazardous materials, terrorism preparedness, venomous bites and stings and environmental and workplace exposures.
1510 S CENTRAL AVE STE 640, Glendale, CA 91204
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Axoderm Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Axoderm Corp, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

David Sherman, M.D.
Nephrology
NPI 1235164294
1510 S CENTRAL AVE SUITE 640
Glendale, CA 91204
(818) 242-3200
✔ PECOS✔ Accepts MedicareSame address
Luke Jacob Narciso
Nurse Practitioner
NPI 1528874401
1211 N VERMONT AVE STE 207
Los Angeles, CA 90029
(323) 426-9480
✔ PECOS✔ Accepts Medicare3.0 mi
Bevien Monte, FNP
Nurse Practitioner
NPI 1548951338
8510 BALBOA BLVD STE 150
Northridge, CA 91325
(818) 654-3400
✔ PECOS✔ Accepts Medicare16 mi
Sarah Lay
Nurse Practitioner
NPI 1225848476
17602 MARTHA AVE
Cerritos, CA 90703
(562) 714-4657
✔ PECOS✔ Accepts Medicare21 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 Axoderm Corp's NPI number?

The NPI number for Axoderm Corp is 1891675674. It was assigned to this organization in the NPPES registry on September 3, 2025.

Where is Axoderm Corp located?

Axoderm Corp is located at 1510 S Central Ave Ste 640, Glendale, CA 91204. The listed phone number is (310) 933-5054.

What is Axoderm Corp's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Medical Toxicology, with taxonomy code 207PT0002X.

Is Axoderm Corp enrolled in Medicare?

Yes. Axoderm Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Axoderm Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Axoderm Corp. 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 (3) and Nephrology (1). Of these, 1 practice at this address and 2 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 Axoderm Corp was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.