Individual provider Active NPI

Naeiri Khachkian

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1215442520
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294174 Issued in CA
Practice address
2701 W Alameda Ave Ste 206
Burbank, CA 91505-4406
Phone
(818) 579-2370
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294174 CA Primary

Addresses

Primary practice location

2701 W Alameda Ave Ste 206
Burbank, CA 91505-4406

Mailing address

2701 W Alameda Ave Ste 206
Burbank, CA 91505-4406
Phone (818) 579-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211002876 CA Practitioner - Physical Therapist in Private Practice 9830457399 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Move Physical Therapy PC Physical Therapist CurrentSince May 1, 2021 Accepting new patients
Feld Care Therapy Inc Physical Therapist CurrentSince Jan 22, 2021 Accepting new patients
Feld Care Therapy Inc Physical Therapist Past Accepting new patients

Locations

100 E Thousand Oaks Blvd
Ste 237
Thousand Oaks, CA 91360
Phone (818) 926-9057

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1215442520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE STE 206",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054406",
            "telephone_number": "818-579-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE STE 206",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054406",
            "telephone_number": "818-579-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHACHKIAN",
        "first_name": "NAEIRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.