Individual provider Active NPI

Vazrik Galstjan, P.A.

  • Surgical Physician Assistant
  • Burbank, CA
National Provider Identifier
1174729768
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 17680 Issued in CA
Practice address
2625 W Alameda Ave
#116
Burbank, CA 91505-4806
Phone
(818) 841-3936
Fax
(818) 841-5974
NPI assigned
Jun 21, 2007
Last updated
Jan 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 17680 CA Primary

Addresses

Primary practice location

2625 W Alameda Ave
#116
Burbank, CA 91505-4806

Mailing address

2625 W Alameda Ave
#116
Burbank, CA 91505-4806
Phone (818) 841-3936

Other identifiers 1

IdentifierTypeStateIssuer
PA 17680OtherCAPHYSICIAN ASSISTANT ID

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
I20060511000248 CA Practitioner - Physician Assistant 7214948751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

3413 W Pacific Ave
Suite 100
Burbank, CA 91505-1598
Phone (818) 561-7589

3413 W Pacific Ave
Suite 100And200
Burbank, CA 91505-1555
Phone (818) 841-3936

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-6049

503 S Buena Vista St
Suite 101
Burbank, CA 91505-4809
Phone (818) 869-7630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
72.95
Promoting interoperability
90
Improvement activities
40
Cost
68.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
17680CAMDPediatric Dentist
PA 17680CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Surgery Specialists Burbank CurrentSince Nov 7, 2015 Accepting new patients
Orthopaedic Surgery Specialists Burbank CurrentSince Nov 7, 2015 Accepting new patients
Providence Facey Medical Foundation CurrentSince Jan 10, 2025 Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

2625 W Alameda Ave
Ste 116
Burbank, CA 91505
Phone (818) 841-3936

3413 W Pacific Ave
Ste 100
Burbank, CA 91505
Phone (818) 579-2408

3413 W Pacific Ave
Ste 100200
Burbank, CA 91505
Phone (818) 841-3936

3413 W Pacific Ave
Ste 200
Burbank, CA 91505
Phone (818) 841-3936

1300 S Central Ave
Glendale, CA 91204
Phone (818) 579-2395

1310 S Central Ave
Glendale, CA 91204
Phone (818) 579-2366

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: vgalstjan435855@oc.providencedirect.org

Organizations & group practices 5

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 2

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1174729768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE",
            "address_2": "#116",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054806",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE",
            "address_2": "#116",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054806",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALSTJAN",
        "first_name": "VAZRIK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 17680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT ID",
            "identifier": "PA 17680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.