Individual provider Active NPI

Stephan Simonian, M.D.

  • Mental Health Counselor
  • Glendale, CA
National Provider Identifier
1104924208
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C50787 Issued in CA
Practice address
1141 N Brand Blvd
Suite # 306
Glendale, CA 91202
Phone
(818) 551-1118
Fax
(818) 551-1955
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C50787 CA Primary

Addresses

Primary practice location

1141 N Brand Blvd
Suite # 306
Glendale, CA 91202

Mailing address

1141 N Brand Blvd
Suite # 306
Glendale, CA 91202-2511
Phone (818) 551-1118

Other identifiers 1

IdentifierTypeStateIssuer
00C507870MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040117000189 CA Practitioner - PsychiatryPractitioner - Geriatric PsychiatryPractitioner - Pulmonary Disease 1557262086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1974
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1141 N Brand Blvd
Suite 306
Glendale, CA 91202-3659
Phone (818) 551-1118

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50787CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephan Simonian MD Apc CurrentSince Mar 2, 2010 Accepting new patients

Locations

1141 N Brand Blvd
Ste 306
Glendale, CA 91202
Phone (818) 409-9900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104924208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N BRAND BLVD",
            "address_2": "SUITE # 306",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022511",
            "telephone_number": "818-551-1118",
            "fax_number": "818-551-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N BRAND BLVD",
            "address_2": "SUITE # 306",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91202",
            "telephone_number": "818-551-1118",
            "fax_number": "818-551-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIAN",
        "first_name": "STEPHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "C50787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C507870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.