Individual provider Active NPI

Amairani Shirvanian

  • Physician Assistant
  • Fullerton, CA
National Provider Identifier
1245917434
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65492 Issued in CA
Practice address
1950 Sunny Crest Dr Ste 3500
Fullerton, CA 92835-3646
Phone
(714) 408-4249
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65492 CA Primary

Addresses

Primary practice location

1950 Sunny Crest Dr Ste 3500
Fullerton, CA 92835-3646

Mailing address

1950 Sunny Crest Dr Ste 3500
Fullerton, CA 92835-3646
Phone (714) 408-4249

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
I20260226001556 CA Practitioner - Physician Assistant 6406337583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 3500
Fullerton, CA 92835-3646
Phone (714) 408-4249

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65492CAMDPharmacist
PA65492CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Feb 9, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Feb 9, 2026 Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

1950 Sunny Crest Dr
Ste 3500
Fullerton, CA 92835
Phone (714) 408-4249

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 and National Provider Directory roles.

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1245917434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 3500",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353646",
            "telephone_number": "714-408-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 3500",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353646",
            "telephone_number": "714-408-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRVANIAN",
        "first_name": "AMAIRANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.