NPIMap

Organization Active NPI

Ararat Home of Los Angeles, Inc.

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1003958356
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000045 Issued in CA
Legal business name
ARARAT HOME OF LOS ANGELES, INC.
Practice address
2373 Colorado Blvd
Los Angeles, CA 90041-1157
Phone
(323) 256-8012
Fax
(323) 256-8146
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Mr. Derik Ghookasian
Title
Coo
Phone
(323) 256-8012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 970000045 CA Primary

Addresses

Primary practice location

2373 Colorado Blvd
Los Angeles, CA 90041-1157

Mailing address

2373 Colorado Blvd
Los Angeles, CA 90041-1157
Phone (323) 256-8012

Other identifiers 1

IdentifierTypeStateIssuer
LTC55126FMedicaidCA

Other names 1

  • Ararat Convalescent Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140916001818 CA Part A Provider - Skilled Nursing Facility 7012136542 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 555126

Legal name
ARARAT HOME OF LOS ANGELES INC.
Doing business as
ARARAT CONVALESCENT HOSPITAL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 20, 1980
Last certification
Oct 6, 2024
Beds
42
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 30, 1953 in CA
Enrollment address
2373 Colorado Blvd
Los Angeles, CA 90041-1157
Nursing home name
ARARAT CONVALESCENT HOSPITAL

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sinan Sinanian Individual Corporate DirectorChairman/Board Member Apr 7, 2022
Derik Ghookasian Individual Corporate DirectorChief Operating Officer Nov 28, 2015
Peter S Darakjian Individual Corporate DirectorBoard Member Apr 1, 2010
Samvel Hmayakyan Individual Operational/Managerial Control Jul 1, 2013
Adp of the SNF Jul 1, 2013
Joseph H Kanimian Individual Corporate DirectorBoard Member Apr 1, 2008
Ararat Home of Los Angeles Inc. Organization, Los Angeles, CA Non-profit 5% Or Greater Direct Ownership Interest May 30, 1980 100%
Operational/Managerial Control May 30, 1980
Varsenik H Keshishyan Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Robert Taylor Individual Corporate DirectorBoard Member Aug 24, 2023

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ararat Nursing FacilityMission Hills, CA, CCN 555579 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1993
Ararat Post AcuteGlendale, CA, CCN 555616 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 28, 2023
Feb 28, 2023
Feb 28, 2023

National Provider Directory

National Provider Directory
Tax ID family
Ararat Home of Los Angeles Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2370 Colorado Blvd
Los Angeles, CA 90041

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ararat Convalescent HospitalCCN 555126
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 20, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4236.8 residents per day on average
Penalties (3 years)
1Fines totaling $10,039

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2132239Ararat Convalescent Hospital2373 Colorado Blvd., Los Angeles, CA 90041Certificate of waiverJun 13, 2027

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1003958356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411157",
            "telephone_number": "323-256-8012",
            "fax_number": "323-256-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411157",
            "telephone_number": "323-256-8012",
            "fax_number": "323-256-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARARAT HOME OF LOS ANGELES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "GHOOKASIAN",
        "authorized_official_first_name": "DERIK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "323-256-8012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55126F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ararat Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.