Individual provider Active NPI

Yervand Set Agayan, DO

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1023216173
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9932 Issued in CA
Practice address
800 S Central Ave
Ste 306
Glendale, CA 91204-4370
Phone
(818) 242-5300
Fax
(818) 244-5850
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9932 CA Primary

Addresses

Primary practice location

800 S Central Ave
Ste 306
Glendale, CA 91204-4370

Mailing address

800 S Central Ave
Ste 306
Glendale, CA 91204-4370
Phone (818) 242-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000202 CA Practitioner - Family Practice 3072695071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 S Centeal Ave
Suite 306
Glendale, CA 91204-4644
Phone (818) 242-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9932CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yervand Darven Set-Agayan DO PC Family Medicine CurrentSince Jun 1, 2009 Accepting new patients
Dignity Health Past Accepting new patients

Locations

800 S Central Ave
Ste 306
Glendale, CA 91204
Phone (818) 242-5300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1023216173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "STE 306",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-242-5300",
            "fax_number": "818-244-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "STE 306",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-242-5300",
            "fax_number": "818-244-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SET AGAYAN",
        "first_name": "YERVAND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.