Missak Kltchian, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A52368 Issued in CA

Practice address

4645 Hollywood Blvd
Suite 4
Los Angeles, CA 90027-5455

Phone

(323) 661-4500

Fax

(323) 661-3260

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comcare Primary Medical Group a California General PartnershipGroup PAC ID 2860770252, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Simple Soul Home Health Care, Inc. Home health agency, Van Nuys, CA, CCN 757570
• La Prime Home Health, Inc. Home health agency, North Hollywood, CA, CCN 559575
• Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mkmd@kmm-ca.direct.office.nextgen.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Sunrise Home Health Services, Inc.

  • Home Health Agency
  • Glendale, CA
  • NPI 1043733421

  Contracted Managing Employee

  CMS ownership

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.

• Comcare Primary Medical Group a California General Partnership

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1578901237
  Medicare reassignment Care Compare group NPD
• Missak Kltchian MD Inc.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1932695079
  Medicare reassignment NPD Authorized official
• Razmik Ohanjanian MD Inc

  • Cardiovascular Disease Physician
  • Glendale, CA
  • NPI 1144535246
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cha Hollywood Medical Center, LP

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  Care Compare affiliation
• La Prime Home Health Inc

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1689273625
  Care Compare affiliation
• Simple Soul Home Health Care, Inc.

  • Home Health Agency
  • Van Nuys, CA
  • NPI 1053062125
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1255359840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 HOLLYWOOD BLVD",
            "address_2": "SUITE 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275455",
            "telephone_number": "323-661-4500",
            "fax_number": "323-661-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 HOLLYWOOD BLVD",
            "address_2": "SUITE 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275455",
            "telephone_number": "323-661-4500",
            "fax_number": "323-661-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLTCHIAN",
        "first_name": "MISSAK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A523681",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Klooster, MD
• Jessica Klopfenstein
• Dennis S. Klos, PH.D.
• Jeanette Klotz, CRNA
• Thomas Albert Klotz, M.D.
• Katheryn Klubak
• Cynthia Kludt, LMFT
• Julianne Kluft
• John Klutke
• Rupa Chadha Knafou

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.