Individual provider Active NPI

Aileen Ambartsumyan, FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1194405787
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027985 Issued in CA
Practice address
519 E Broadway
Glendale, CA 91205-1110
Phone
(818) 409-3020
NPI assigned
Jul 19, 2023
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 95027985 CA Primary
Registered Nurse 163W00000X 95169219 CA

Addresses

Primary practice location

519 E Broadway
Glendale, CA 91205-1110

Mailing address

1401 Valley View Rd Apt 109
Glendale, CA 91202-4408
Phone (818) 275-7755

Other practice location 1

1401 Valley View Rd Apt 109
Glendale, CA 91202-4408
Phone (818) 275-7755

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
I20241120000090 CA Practitioner - Nurse Practitioner 9133501901 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
Group practices

Practice addresses (Care Compare)

519 E Broadway
Glendale, CA 91205-1110
Phone (818) 409-3020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
All for Health Health for All Inc CurrentSince Nov 11, 2024 Accepting new patients
All for Health Health for All Inc Current Accepting new patients
All for Health Health for All Inc CurrentSince Nov 11, 2024 Accepting new patients
Health Is Wealth Home Care Services Inc CurrentSince Jul 9, 2021 Accepting new patients

Locations

519 E Broadway
Glendale, CA 91205
Phone (818) 409-3020

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aileen.ambartsumyannp.p1@direct.afh.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Health Is Wealth Home Care Services IncLos Angeles, CA, CCN 757276 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Jul 9, 2021
Jul 9, 2021
Jul 9, 2021
Jul 9, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194405787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 VALLEY VIEW RD APT 109",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024408",
            "telephone_number": "818-275-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051110",
            "telephone_number": "818-409-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Valley View Rd Apt 109",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912024408",
            "country_code": "US",
            "telephone_number": "818-275-7755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBARTSUMYAN",
        "first_name": "AILEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027985",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95169219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.