Individual provider Active NPI

Siranuysh Salmastyan, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1245527308
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A132643 Issued in CA
Practice address
1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone
(818) 645-0704
NPI assigned
Jul 8, 2011
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A132643 CA Primary

Addresses

Primary practice location

1401 S Grand Ave
Los Angeles, CA 90015-3010

Mailing address

706 E Harvard St
2
Glendale, CA 91205-1156
Phone (818) 645-0704

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
I20151006002567 CA Practitioner - Internal Medicine 9335111624 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Group of Montebello IncGroup PAC ID 2264715143, 55 clinicians

Practice addresses (Care Compare)

1701 Santa Anita Ave
S El Monte, CA 91733-3411
Phone (626) 579-7777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132643CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Im-FSR Inc. CurrentSince Jun 1, 2025 Accepting new patients
Careconnectmd Ca PC CurrentSince Oct 1, 2021 Accepting new patients
Community Foundation Medical Group CurrentSince Sep 10, 2015 Accepting new patients
Hospitalist Group of Montebello Inc CurrentSince Oct 7, 2017 Accepting new patients
Community Foundation Medical Group Internal Medicine CurrentSince Sep 10, 2015 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2335 E Kashian Ln
Ste 450
Fresno, CA 93701
Phone (559) 233-7700

2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

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 2

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1245527308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 E HARVARD ST",
            "address_2": "2",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051156",
            "telephone_number": "818-645-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "818-645-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMASTYAN",
        "first_name": "SIRANUYSH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A132643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.