Hagop Jack Mkroyan, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95012171 Issued in CA

Practice address

1111 N Brand Blvd Ste 312
Glendale, CA 91202-3071

Phone

(323) 230-0017

NPI assigned

Jul 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Penciu Medical ApmcGroup PAC ID 2062827132, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: penciumedical.jackmkroyan@147949.advancedmd-direct.com

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.

• Penciu Medical Apmc

  • Psychiatry Physician
  • Glendale, CA
  • NPI 1295351740
  Medicare reassignment Care Compare group NPD
• KLC Consultants, PC

  • Psychiatry Physician
  • Agoura Hills, CA
  • NPI 1053808899
  Medicare reassignment NPD
• Nutrix Care Partners, a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
  • NPI 1578255261
  NPD Authorized official
• Dadoyan Behavioral Medical Group Inc

  • Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1841687878
  Medicare reassignment
• Peak Wellness Psychiatry, a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1376184168
  NPD (past)

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1104479179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N BRAND BLVD STE 312",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023071",
            "telephone_number": "323-230-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N BRAND BLVD STE 312",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023071",
            "telephone_number": "323-230-0017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2667 Camino Del Rio S Ste 301-8",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083707",
            "country_code": "US",
            "telephone_number": "888-909-8676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MKROYAN",
        "first_name": "HAGOP",
        "middle_name": "JACK",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-18",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "841786",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelina Mkhitarian
• Hovakim Mkhitarian
• Mkhitaryan Medical Corp
• Lusine Mkhitaryan
• Vahe Mkhitaryan
• Mery Mkrtchian
• Gayane Mkrtchyan, NP
• Liana Mkrtchyan
• Lida Mkrtchyan
• Linda Mkrtchyan, AMFT

• Psychiatric/Mental Health Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.