Individual provider Active NPI

Carol Aivazian, O.D.

  • Optometrist
  • Valencia, CA
National Provider Identifier
1164594362
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11039T Issued in CA
Practice address
23300 Cinema Dr Ste 210
Valencia, CA 91355-1776
Phone
(661) 287-3939
Fax
(661) 287-3838
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11039T CA Primary

Addresses

Primary practice location

23300 Cinema Dr Ste 210
Valencia, CA 91355-1776

Mailing address

23300 Cinema Dr Ste 210
Valencia, CA 91355-1776
Phone (661) 287-3939

Other identifiers 1

IdentifierTypeStateIssuer
WOP11039COtherCAMEDICARE PTAN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121000856 CA Practitioner - Optometry 5698794493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23300 Cinema Dr
Valencia, CA 91355-1776
Phone (661) 287-3939

9911 Topanga Canyon Blvd
Chatsworth, CA 91311-3602
Phone (818) 678-9133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11039TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carol Aivazian O D Optometric Corporation Optometrist CurrentSince Jan 17, 2017 Accepting new patients

Locations

9911 Topanga Canyon Blvd
Chatsworth, CA 91311
Phone (818) 517-4644

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1164594362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 CINEMA DR STE 210",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551776",
            "telephone_number": "661-287-3939",
            "fax_number": "661-287-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23300 CINEMA DR STE 210",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551776",
            "telephone_number": "661-287-3939",
            "fax_number": "661-287-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIVAZIAN",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11039T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WOP11039C",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.