NPIMap

Individual provider Active NPI

Elizabeth Grigoryan

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1083198550
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A174398 Issued in CA
Practice address
662 W Broadway Ste C
Glendale, CA 91204-1008
Phone
(818) 664-4112
Fax
(818) 671-0105
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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 A174398 CA Primary

Addresses

Primary practice location

662 W Broadway Ste C
Glendale, CA 91204-1008

Mailing address

662 W Broadway Ste C
Glendale, CA 91204-1008
Phone (818) 664-4112

Other practice location 1

1400 S Grand Ave
Los Angeles, CA 90015-3048
Phone (213) 744-0801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

445 W Broadway
Glendale, CA 91204-1208

Hospital & facility affiliations

  • Medlight Home Health Care, Inc Home health agency, Sherman Oaks, CA, CCN 559678
  • Orange Home Health, Inc. Home health agency, Van Nuys, CA, CCN 757211
  • Charity Sisters Home Health Care Home health agency, Granada Hills, CA, CCN 757425
  • Saint George Home Health Home health agency, Glendale, CA, CCN 753192
  • Enlighten Hospice, LLC Hospice, Chatsworth, CA, CCN B51509
  • Icare Hospice Services, Inc Hospice, N Hollywood, CA, CCN B31565
  • Heart 2 Heart Hospice Care, Inc Hospice, Burbank, CA, CCN 751610
  • Pacific Palliative Services Inc Hospice, N Hollywood, CA, CCN A11625
  • Prestige Hospice Inc Hospice, Woodland Hills, CA, CCN B41536
  • Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058
  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A174398CAMDFamily Medicine Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Memorial Medical Group Inc Past Accepting new patients
L a County Hospice Inc Family Medicine PastSince Mar 18, 2024 Accepting new patients
Glendale Adventist Medical Center PastSince Jul 17, 2023 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: elizabeth.grigoryan.1@25038.direct.athenahealth.com

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.

Hospital & facility affiliations 10

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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1083198550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 W BROADWAY STE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041008",
            "telephone_number": "818-664-4112",
            "fax_number": "818-671-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 W BROADWAY STE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041008",
            "telephone_number": "818-664-4112",
            "fax_number": "818-671-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153048",
            "country_code": "US",
            "telephone_number": "213-744-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGORYAN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A174398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.