Organization Active NPI

High Desert Pulmonary Associates, Inc

  • Pulmonary Disease Physician
  • Apple Valley, CA
National Provider Identifier
1124681325
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
HIGH DESERT PULMONARY ASSOCIATES, INC
Practice address
18092 Wika Rd Ste 220
Apple Valley, CA 92307-2132
Phone
(760) 515-6260
Fax
(949) 863-8505
NPI assigned
Apr 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Artur Grigoriyan, MDNPI 1922251792
Title
President
Phone
(203) 931-5588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

18092 Wika Rd Ste 220
Apple Valley, CA 92307-2132

Mailing address

18092 Wika Rd Ste 220
Apple Valley, CA 92307-2132
Phone (760) 515-6260

Other practice location 1

18300 US Highway 18
Apple Valley, CA 92307-2206
Phone (760) 242-2311

Other practice location 2

15248 11th St
Victorville, CA 92395-3704
Phone (760) 245-8691

Other practice location 3

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNEED NPI # FIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190618002993 CA Part B Supplier - Clinic/Group Practice 0648504050 Receives reassigned benefits from 2 practitioners
Practice locations: Apple Valley, CA; Barstow, CA; Victorville, CA

National Provider Directory

National Provider Directory

Locations

18092 Wika Rd
Ste 220
Apple Valley, CA 92307
Phone (760) 515-6260

18092 Wika Rd
Ste 130
Apple Valley, CA 92307
Phone (442) 292-2358

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1124681325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18092 WIKA RD STE 220",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072132",
            "telephone_number": "760-515-6260",
            "fax_number": "949-863-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18092 WIKA RD STE 220",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072132",
            "telephone_number": "760-515-6260",
            "fax_number": "949-863-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18300 US Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072206",
            "country_code": "US",
            "telephone_number": "760-242-2311",
            "fax_number": "760-946-8714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15248 11th St",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923953704",
            "country_code": "US",
            "telephone_number": "760-245-8691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16850 Bear Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923955794",
            "country_code": "US",
            "telephone_number": "760-241-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HIGH DESERT PULMONARY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "GRIGORIYAN",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-931-5588",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEED NPI # FIRST",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.