Active NPI
Anahit Ana Grigoryan
- Durable Medical Equipment & Medical Supplies
- Los Angeles, CA
National Provider Identifier
1194093393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 101183
- Practice address
- 4448 Eagle Rock Blvd
Suite a
Los Angeles, CA 90041-3512 - Phone
- (323) 257-5535
- Fax
- (323) 257-5396
- NPI assigned
- Dec 2, 2011
- Last updated
- Dec 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 101183 | CA | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 18131 | CA | |
| Prosthetic/Orthotic Supplier | 335E00000X | C17386 | CA |
Addresses
Primary practice location
4448 Eagle Rock Blvd
Suite a
Los Angeles, CA 90041-3512
Mailing address
4448 Eagle Rock Blvd
Suite a
Los Angeles, CA 90041-3512
Phone (323) 257-5535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DME02836F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101183 | CA | MD | Durable Medical Equipment & Medical Supplies |
| C17386 | CA | MD | Prosthetic/Orthotic Supplier |
| 18131 | CA | MD | Surgical Physician Assistant |
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.
-
dba RD Universal Medical Supply
- Durable Medical Equipment & Medical Supplies
- Los Angeles, CA
- NPI 1538573183
-
- Durable Medical Equipment & Medical Supplies
- Los Angeles, CA
- NPI 1629080700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322784000000",
"number": "1194093393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4448 EAGLE ROCK BLVD",
"address_2": "SUITE A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900413512",
"telephone_number": "323-257-5535",
"fax_number": "323-257-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4448 EAGLE ROCK BLVD",
"address_2": "SUITE A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900413512",
"telephone_number": "323-257-5535",
"fax_number": "323-257-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGORYAN",
"first_name": "ANAHIT",
"middle_name": "ANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-02",
"last_updated": "2011-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "101183",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "18131",
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "CA",
"license": "C17386",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DME02836F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.