Individual provider Active NPI

Nelli Berberyan, NP

  • Family Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1083370936
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95018416 Issued in CA
Practice address
14411 Hamlin St
Van Nuys, CA 91401-1467
Phone
(818) 994-0616
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X NP95018416 CA Primary

Addresses

Primary practice location

14411 Hamlin St
Van Nuys, CA 91401-1467

Mailing address

11856 Balboa Blvd # 482
Granada Hills, CA 91344-2753

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
I20211220000655 CA Order and Referring Only - Nurse Practitioner 4486045804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95018416CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Future Senior Living Current Accepting new patients
Future Senior Living Current Accepting new patients

Organizations & group practices 2

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1083370936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11856 BALBOA BLVD # 482",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 HAMLIN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011467",
            "telephone_number": "818-994-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERYAN",
        "first_name": "NELLI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95018416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.