NPIMap

Individual provider Active NPI

Alen Mirzaian, M.D.

  • Internal Medicine Physician
  • Glendale, CA
National Provider Identifier
1043209554
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A88445 Issued in CA
Practice address
1818 Verdugo Blvd Ste 401
Glendale, CA 91208-1421
Phone
(818) 790-1145
NPI assigned
Oct 18, 2005
Last updated
May 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A88445 CA Primary

Addresses

Primary practice location

1818 Verdugo Blvd Ste 401
Glendale, CA 91208-1421

Mailing address

1818 Verdugo Blvd Ste 401
Glendale, CA 91208-1421
Phone (818) 790-1145

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
I20050726000992 CA Practitioner - Internal Medicine 2466489927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1818 Verdugo Blvd
Suite 401
Glendale, CA 91208-1421
Phone (818) 790-1145

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88445CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Adventist Medical Center Past Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. Internal Medicine Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amirzaian@vhmg-ca.direct.office.nextgen.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Superior Home Health Services, IncTujunga, CA, CCN 058498 Home health agency Contracted Managing Employee Feb 1, 2012

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 3

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 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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1043209554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD STE 401",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081421",
            "telephone_number": "818-790-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD STE 401",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081421",
            "telephone_number": "818-790-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZAIAN",
        "first_name": "ALEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A88445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.