Individual provider Active NPI

Jacob Sahakian

  • Family Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1154888667
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011211 Issued in CA
Practice address
201 S Buena Vista St Ste 410
Burbank, CA 91505-4571
Phone
(818) 845-3773
NPI assigned
Feb 21, 2019
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95011211 CA Primary
Registered Nurse 163W00000X 95042336 CA

Addresses

Primary practice location

201 S Buena Vista St Ste 410
Burbank, CA 91505-4571

Mailing address

201 S Buena Vista St Ste 410
Burbank, CA 91505-4571
Phone (818) 845-3773

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
I20190408002212 CA Practitioner - Nurse Practitioner 3274874839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

201 S Buena Vista St
Suite 410
Burbank, CA 91505-4571
Phone (818) 845-3773

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95042336CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Healthcare Partners PC CurrentSince Oct 1, 2022 Accepting new patients
Skyline Urology Current Accepting new patients
Urology Institute of the South Bay Current Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

201 S Buena Vista St
Ste 410
Burbank, CA 91505
Phone (818) 845-3773

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

50 Alessandro Pl
Ste 410
Pasadena, CA 91105
Phone (626) 793-7114

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

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1154888667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST STE 410",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054571",
            "telephone_number": "818-845-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST STE 410",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054571",
            "telephone_number": "818-845-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAKIAN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011211",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95042336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.