Mary Demirjian, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13710 Issued in CA

Practice address

17283 Ventura Blvd
Encino, CA 91316-4007

Phone

(818) 990-0300

Fax

(818) 990-4854

NPI assigned

Jul 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mary Demirjian, O.D., Inc.

  • Optometrist
  • Encino, CA
  • NPI 1366744856
  Medicare reassignment NPD Authorized official
• Allen B. Yeroushalmi, M.D., P.C.

  • Ophthalmology Physician
  • Beverly Hills, CA
  • NPI 1245740711
  NPD (past)

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1043449655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17283 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164007",
            "telephone_number": "818-990-0300",
            "fax_number": "818-990-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17283 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164007",
            "telephone_number": "818-990-0300",
            "fax_number": "818-990-4854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24480 Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913212873",
            "country_code": "US",
            "telephone_number": "661-505-7133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38024 47th St E Ste F",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935523120",
            "country_code": "US",
            "telephone_number": "661-441-4455",
            "fax_number": "661-878-8677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMIRJIAN",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140139",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8495739",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1366744856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Delisser, SLP
• Deluxe Durable Medical Supply LLC
• Frank Joseph Demarco, D.C.
• Samantha Lynn Deming, LMFT
• Ashley Demirchyan
• Janelle Dempsey
• Jack Mark Dender, M.D., PSY.D.
• Dental Image Solutions Corp (den-med-pro.com)
• Daljeet Deol
• Candace L Depuy, PHD

• Optometrist in Encino, CA
• Providers in Encino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.