Individual provider Active NPI

Anush Petrosyan, NP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1245986645
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018482 Issued in CA
Practice address
519 E Broadway
Glendale, CA 91205-1110
Phone
(818) 409-3020
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018482 CA Primary

Addresses

Primary practice location

519 E Broadway
Glendale, CA 91205-1110

Mailing address

519 E Broadway
Glendale, CA 91205-1110
Phone (184) 093-0208

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
I20231106000790 CA Practitioner - Nurse Practitioner 7517314024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All for Health Health for All IncGroup PAC ID 5698734788, 37 clinicians

Practice addresses (Care Compare)

401 S Glenoaks Blvd
Suite 101
Burbank, CA 91502-2707
Phone (818) 748-1740

5160 Vineland Ave
Suite 109
North Hollywood, CA 91601-3888
Phone (818) 738-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018482CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All for Health Health for All Inc CurrentSince Oct 1, 2023 Accepting new patients
All for Health Health for All Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

519 E Broadway
Glendale, CA 91205
Phone (818) 409-3020

800 S Central Ave
Ste 308
Glendale, CA 91204
Phone (818) 332-2233

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: anush.petrosyannp.p1@direct.afh.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1245986645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051110",
            "telephone_number": "184-093-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051110",
            "telephone_number": "818-409-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSYAN",
        "first_name": "ANUSH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.