Active NPI
Mari Anna Hareyan, PA
- Physician Assistant
- Van Nuys, CA
National Provider Identifier
1255004503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 14232 Gilmore St # 101
Van Nuys, CA 91401-1979 - Phone
- (818) 391-8835
- NPI assigned
- Jul 30, 2021
- Last updated
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
14232 Gilmore St # 101
Van Nuys, CA 91401-1979
Mailing address
14232 Gilmore St # 101
Van Nuys, CA 91401-1979
Phone (818) 391-8835
Other names 1
- Mary Anna Hareyan
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Mobile Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
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- Burbank, CA
- NPI 1144989401
-
dba The Mobile DRS
- Family Medicine Physician
- Glendale, CA
- NPI 1588439061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1255004503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14232 GILMORE ST # 101",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011979",
"telephone_number": "818-391-8835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14232 GILMORE ST # 101",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011979",
"telephone_number": "818-391-8835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAREYAN",
"first_name": "MARI",
"middle_name": "ANNA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "HAREYAN",
"middle_name": "ANNA",
"credential": "PA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.