Organization Active NPI

Nersissian Health Management Group

  • Multi-Specialty Clinic/Center
  • Glendale, CA
National Provider Identifier
1235714825
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NERSISSIAN HEALTH MANAGEMENT GROUP
Practice address
1030 S Glendale Ave Ste 507
Glendale, CA 91205-2820
Phone
(818) 548-4668
Fax
(818) 548-8863
NPI assigned
Mar 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Mrs. Sonia Nersissian
Title
President
Phone
(818) 548-4668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1030 S Glendale Ave Ste 507
Glendale, CA 91205-2820

Mailing address

1030 S Glendale Ave Ste 507
Glendale, CA 91205-2820
Phone (818) 548-4668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210421002535 CA Part B Supplier - Clinic/Group Practice 5496163958 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA
O20240227003533 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5496163958 Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1235714825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE STE 507",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052820",
            "telephone_number": "818-548-4668",
            "fax_number": "818-548-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE STE 507",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052820",
            "telephone_number": "818-548-4668",
            "fax_number": "818-548-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NERSISSIAN HEALTH MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "NERSISSIAN",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-548-4668",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.