Pediatric Associates Medical Group, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PEDIATRIC ASSOCIATES MEDICAL GROUP, INC.

Practice address

4330 Fulton Ave
Sherman Oaks, CA 91423-3907

Phone

(818) 784-1102

Fax

(818) 784-1653

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas A Glassman, M.D.

Title

Vice President of Corporation

Phone

(818) 784-1102

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mikayel Abramyan, M.D.

  • Pediatrics Physician
  • Sherman Oaks, CA
  • NPI 1578755252
  NPD (past)
• Ilona Kleiner, M.D.

  • Pediatrics Physician
  • Sherman Oaks, CA
  • NPI 1043227143
  NPD (past)
• Michael Lin, M.D.

  • Pediatrics Physician
  • Sherman Oaks, CA
  • NPI 1598111387
  NPD (past)
• Angelee Kruger Reiner, MD

  • Pediatrics Physician
  • Tarzana, CA
  • NPI 1962541805
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255366712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 FULTON AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233907",
            "telephone_number": "818-784-1102",
            "fax_number": "818-784-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 FULTON AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233907",
            "telephone_number": "818-784-1102",
            "fax_number": "818-784-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLASSMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "818-784-1102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yana Pechenik, PA
• Anna Grayce Pedersen
• Pediatric and Family Medical Center
• Pediatric and Family Medical Center
• Pediatric and Family Medical Center
• Pedro Monzon Pelcastre, AA SOCIAL/BEHAVIORAL
• Nechemia B Peleg, MD
• Troynall Pelts
• Shanna Massachi Penias, OTR/L
• Eissa Belinda Penilla

• Primary Care Clinic/Center in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.