NPIMap

Individual provider Active NPI

Albert A Petrossian, M.D.

  • Urology Physician
  • Long Beach, CA
National Provider Identifier
1003136565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A136810 Issued in CA
Practice address
6226 E Spring St Ste 260
Long Beach, CA 90815-1454
Phone
(562) 283-4876
Fax
(562) 731-2926
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 136810 CA
Student in an Organized Health Care Education/Training Program 390200000X 0116022439 VA
Urology Physician 208800000X A136810 CA Primary

Addresses

Primary practice location

6226 E Spring St Ste 260
Long Beach, CA 90815-1454

Mailing address

6226 E Spring St Ste 260
Long Beach, CA 90815-1454
Phone (562) 283-4876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151104001012 CA Practitioner - Urology 3173761970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Virginia School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
One UrologyGroup PAC ID 2466868922, 2 clinicians

Practice addresses (Care Compare)

6226 E Spring St
Suite 260
Long Beach, CA 90815-1454
Phone (562) 283-4876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection39
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136810CAMDUrology Physician
A136810CAMDUrology Physician
0116022439VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
One Urology Urology CurrentSince Mar 1, 2021 Accepting new patients

Locations

6226 E Spring St
Ste 260
Long Beach, CA 90815
Phone (562) 283-4876

Interoperability endpoints

  • Direct secure messaging: apetrossian370668@direct.memorialcare.org
  • Direct secure messaging: albert.petrossian@490083655483396.direct.elationemr.com
  • Direct secure messaging: albert.petrossian.p1@direct.plannedparenthoodla.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003136565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151454",
            "telephone_number": "562-283-4876",
            "fax_number": "562-731-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151454",
            "telephone_number": "562-283-4876",
            "fax_number": "562-731-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSSIAN",
        "first_name": "ALBERT",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "136810",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116022439",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A136810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.