Individual provider Active NPI

Andrey Safaryan, RN

  • Registered Nurse
  • Oceanside, CA
National Provider Identifier
1235593856
Registry record updated Apr 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
764831 Issued in CA
Practice address
5381 Gooseberry Way
Oceanside, CA 92057-4633
Phone
(760) 687-8503
NPI assigned
Apr 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 764831 CA Primary

Addresses

Primary practice location

5381 Gooseberry Way
Oceanside, CA 92057-4633

Mailing address

5381 Gooseberry Way
Oceanside, CA 92057-4633

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
764831CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460160000000",
    "number": "1235593856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5381 GOOSEBERRY WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5381 GOOSEBERRY WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574633",
            "telephone_number": "760-687-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFARYAN",
        "first_name": "ANDREY",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-09",
        "last_updated": "2016-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "764831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.