Individual provider Active NPI

Edgar Agvanyan, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1225288582
Registry record updated Jun 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A105325 Issued in CA
Practice address
544 N Glendale Ave
Verdugo Hills Medical Associates
Glendale, CA 91206-3311
Phone
(818) 241-4331
Fax
(818) 241-2253
NPI assigned
Sep 23, 2008
Last updated
Jun 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A105325 CA Primary

Addresses

Primary practice location

544 N Glendale Ave
Verdugo Hills Medical Associates
Glendale, CA 91206-3311

Mailing address

544 N Glendale Ave
Verdugo Hills Medical Associates
Glendale, CA 91206-3311
Phone (818) 241-4331

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090725000080 CA Practitioner - Family Practice 2567515422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2750 Sycamore Dr
Simi Valley, CA 93065-1500

544 N Glendale Ave
Glendale, CA 91206-3311
Phone (818) 265-2242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105325CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Family Medicine Current Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 14, 2013 Accepting new patients
Dignity Health Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

1560 E Chevy Chase Dr
Ste 245
Glendale, CA 91206
Phone (818) 246-5900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 3

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244332800000",
    "number": "1225288582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 N GLENDALE AVE",
            "address_2": "VERDUGO HILLS MEDICAL ASSOCIATES",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063311",
            "telephone_number": "818-241-4331",
            "fax_number": "818-241-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 N GLENDALE AVE",
            "address_2": "VERDUGO HILLS MEDICAL ASSOCIATES",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063311",
            "telephone_number": "818-241-4331",
            "fax_number": "818-241-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGVANYAN",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2009-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.