Individual provider Active NPI

Sylva Garagulakian, PA-C

  • Physician Assistant
  • Northridge, CA
National Provider Identifier
1215445770
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56226 Issued in CA
Practice address
8330 Reseda Blvd
Northridge, CA 91324-4619
Phone
(818) 996-1051
NPI assigned
Jan 18, 2018
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56226 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

8330 Reseda Blvd
Northridge, CA 91324-4619

Mailing address

1717 N Verdugo Rd Apt 306
Glendale, CA 91208-2945

Other practice location 1

7101 NE 137th Ave
Vancouver, WA 98682-4933
Phone (800) 813-2000

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
I20200210001771 CA Practitioner - Physician Assistant 9537595640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarzana Treatment Centers IncGroup PAC ID 5991897845, 55 clinicians

Practice addresses (Care Compare)

18646 Oxnard St
Tarzana, CA 91356-1411
Phone (800) 996-1051

8330 Reseda Blvd
Northridge, CA 91324-4619
Phone (800) 996-1051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56226CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Treatment Centers, Inc. CurrentSince Dec 11, 2019 Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Dec 11, 2019 Accepting new patients

Locations

8330 Reseda Blvd
Northridge, CA 91324
Phone (818) 534-1820

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sgaragulakian347180@direct.ochin.org

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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1215445770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N VERDUGO RD APT 306",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244619",
            "telephone_number": "818-996-1051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7101 NE 137th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986824933",
            "country_code": "US",
            "telephone_number": "800-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARAGULAKIAN",
        "first_name": "SYLVA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56226",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.