Active NPI
Shant Boshnakian, PA
- Physician Assistant
- Northridge, CA
National Provider Identifier
1114110632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 17078
- Practice address
- 18300 Roscoe Blvd
Northridge, CA 91325-4105 - Phone
- (818) 885-8500
- NPI assigned
- Aug 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 17078 | CA | Primary |
Addresses
Primary practice location
18300 Roscoe Blvd
Northridge, CA 91325-4105
Mailing address
PO Box 12410
Westminster, CA 92685-2410
Phone (866) 234-5107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 17078 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northridge Emergency Medical Group | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Northridge, CA
- NPI 1093771222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1114110632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12410",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926852410",
"telephone_number": "866-234-5107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 ROSCOE BLVD",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913254105",
"telephone_number": "818-885-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSHNAKIAN",
"first_name": "SHANT",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-20",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 17078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.