Individual provider Active NPI

Yevgenya Simonyan

  • Family Medicine Physician
  • North Hollywood, CA
National Provider Identifier
1114737798
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NP95033139 Issued in CA
Practice address
11240 Magnolia Blvd Ste 102
North Hollywood, CA 91601-3790
Phone
(747) 877-8184
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 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 NP95033139 CA Primary

Addresses

Primary practice location

11240 Magnolia Blvd Ste 102
North Hollywood, CA 91601-3790

Mailing address

1630 Shadow Oaks PL
Thousand Oaks, CA 91362-1925

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
I20251023001482 CA Practitioner - Nurse Practitioner 1951899764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11240 Magnolia Blvd
Suite 102
North Hollywood, CA 91601-3790

1141 N Brand Blvd
Suite 302
Glendale, CA 91202-2511

1141 N Brand Blvd
Suite 302
Glendale, CA 91202-3069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95033139CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Pain Clinic Inc CurrentSince Oct 30, 2025 Accepting new patients
Valley Health Medical Group, Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

1141 N Brand Blvd
Ste 302
Glendale, CA 91202
Phone (747) 229-9000

11240 Magnolia Blvd
Ste 102
North Hollywood, CA 91601
Phone (747) 256-8184

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Caring Home Home Care IncBurbank, CA, CCN 757134 Home health agency W-2 Managing Employee
Operational/Managerial Control
May 30, 2023
May 30, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1114737798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SHADOW OAKS PL",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913621925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 MAGNOLIA BLVD STE 102",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013790",
            "telephone_number": "747-877-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONYAN",
        "first_name": "YEVGENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NP95033139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.