Michelle Mathevosian

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

A158866 Issued in CA

Practice address

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Phone

(323) 361-2461

NPI assigned

Mar 21, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Cardiovascular Disease (Cardiology)

Education

R Franklin University of Med & Sci/Chicago Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Children'S Hosp of Los Angeles Hospital, Los Angeles, CA, CCN 053302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Children'S Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment Care Compare group NPD
• Children'S Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)

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

• Childrens Hospital of Los Angeles

  • Children's Hospital
  • Los Angeles, CA
  • NPI 1124073366
  Care Compare affiliation

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1043741267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "BOX 951752, 3108 RRUMC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957419",
            "telephone_number": "310-825-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEVOSIAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A158866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathas House LLC
• Charli A Matheney, BA, MA
• Omar Ali Mather, M.D.
• Gary W Mathern, MD
• Jennie M. Mathess, PSY.D.
• Sipan Mathevosian, M.D.
• Anna John Mathew, M.D.
• Joshua Mathew, MD
• Lucy Mathew, NP
• Mary NMS Mathew, B.A, M.A.

• Pediatric Cardiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.