Individual provider Active NPI

Marie Antionette Minassian, FNP-C

  • Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1154293363
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95037001 Issued in CA
Practice address
800 S Central Ave Ste 307
Glendale, CA 91204-4644
Phone
(818) 646-1414
NPI assigned
Sep 18, 2025
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95037001 CA Primary

Addresses

Primary practice location

800 S Central Ave Ste 307
Glendale, CA 91204-4644

Mailing address

PO Box 964
Montebello, CA 90640-0964
Phone (310) 497-8986

Other practice location 1

8961 W Sunset Blvd
West Hollywood, CA 90069-1807
Phone (323) 388-7012

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
I20260602004208 CA Practitioner - Nurse Practitioner 6204307028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 S Central Ave
Glendale, CA 91204-4370

PO Box
Suite 964
Montebello, CA 90640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95037001CAMDNurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1154293363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906400964",
            "telephone_number": "310-497-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 307",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044644",
            "telephone_number": "818-646-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8961 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900691807",
            "country_code": "US",
            "telephone_number": "323-388-7012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINASSIAN",
        "first_name": "MARIE",
        "middle_name": "ANTIONETTE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95037001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.