Individual provider Active NPI

Tamar Lori Knadjian-Hindin, RN, AGPCNP

  • Gerontology Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1053898924
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95009559 Issued in CA
Practice address
1019 S Central Ave
Glendale, CA 91204-2210
Phone
(818) 244-4374
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95009559 CA Primary

Addresses

Primary practice location

1019 S Central Ave
Glendale, CA 91204-2210

Mailing address

1019 S Central Ave
Glendale, CA 91204-2210
Phone (818) 244-4374

Other names 1

  • Tamar Lori Knadjian Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002167 CA Practitioner - Nurse Practitioner 8224461959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Multi-Specialty Center IncGroup PAC ID 4082953336, 16 clinicians

Practice addresses (Care Compare)

5805 Sepulveda Blvd
Suite 690
Sherman Oaks, CA 91411-2522
Phone (818) 900-6480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95009559CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Multi-Specialty Center Inc CurrentSince Aug 29, 2025 Accepting new patients
Southern California Multi-Specialty Center Inc CurrentSince Aug 29, 2025 Accepting new patients
Providence Saint John's Health Center Past Accepting new patients

Locations

19950 Rinaldi St
Ste 101D
Porter Ranch, CA 91326
Phone (818) 488-5188

18345 Ventura Blvd
Ste 510
Tarzana, CA 91356
Phone (818) 757-7600

5805 Sepulveda Blvd
Ste 690
Van Nuys, CA 91411
Phone (818) 900-6480

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1053898924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042210",
            "telephone_number": "818-244-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042210",
            "telephone_number": "818-244-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNADJIAN-HINDIN",
        "first_name": "TAMAR",
        "middle_name": "LORI",
        "credential": "RN, AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95009559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMAR",
            "last_name": "KNADJIAN",
            "middle_name": "LORI",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.