Individual provider Active NPI

Tigran Abrahamyan, MSN-FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1164144374
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022630 Issued in CA
Practice address
1100 E Broadway Ste 300
Glendale, CA 91205-4643
Phone
(818) 745-2002
NPI assigned
Sep 14, 2022
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022630 CA Primary

Addresses

Primary practice location

1100 E Broadway Ste 300
Glendale, CA 91205-4643

Mailing address

1100 E Broadway Ste 300
Glendale, CA 91205-4643
Phone (818) 745-2002

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
I20240305000704 CA Practitioner - Nurse Practitioner 0143679381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 E Broadway
Suite 300
Glendale, CA 91205-4643
Phone (747) 777-3101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95022630CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tigran Abrahamyan Nursing Inc CurrentSince Jan 25, 2024 Accepting new patients
Green Life Hospice Inc PastSince Nov 29, 2023 Accepting new patients

Locations

1100 E Broadway
Ste 300
Glendale, CA 91205
Phone (747) 777-3101

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, 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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1164144374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E BROADWAY STE 300",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054643",
            "telephone_number": "818-745-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E BROADWAY STE 300",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054643",
            "telephone_number": "818-745-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMYAN",
        "first_name": "TIGRAN",
        "credential": "MSN-FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.