Individual provider Active NPI

Gayaneh Gharakhani, PA-C

  • Medical Physician Assistant
  • Glendale, CA
National Provider Identifier
1124638663
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1323 E Broadway Apt 110
Glendale, CA 91205-4018
Phone
(818) 307-4305
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1323 E Broadway Apt 110
Glendale, CA 91205-4018

Mailing address

1323 E Broadway Apt 110
Glendale, CA 91205-4018
Phone (818) 307-4305

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
I20231027002943 CA Practitioner - Physician Assistant 4486000320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

23600 Telo Ave
Suite 220
Torrance, CA 90505-4039
Phone (310) 534-8400

50 Alessandro PL
Suite 410
Pasadena, CA 91105-3175
Phone (626) 793-7114

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438
  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59822CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Urology Current Accepting new patients
Urology Institute of the South Bay Current Accepting new patients

Locations

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

Interoperability endpoints

  • Direct secure messaging: gayaneh.gharakhani.1@3663.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1124638663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 E BROADWAY APT 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054018",
            "telephone_number": "818-307-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 E BROADWAY APT 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054018",
            "telephone_number": "818-307-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHARAKHANI",
        "first_name": "GAYANEH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.