Individual provider Active NPI

Shakeh Haghnazarian, NP

  • Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1255836904
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95008753 Issued in CA
Practice address
1163 Winchester Ave Apt 6
Glendale, CA 91201-1828
Phone
(818) 522-5396
NPI assigned
Mar 26, 2018
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95008753 CA Primary

Addresses

Primary practice location

1163 Winchester Ave Apt 6
Glendale, CA 91201-1828

Mailing address

1163 Winchester Ave Apt 6
Glendale, CA 91201-1828
Phone (862) 235-4743

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
I20180919001333 CA Practitioner - Nurse Practitioner 9335490028 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RPM Care Coordination PCGroup PAC ID 6002205606, 42 clinicians
Onclick Healthcare IncorporatedGroup PAC ID 9830511260, 63 clinicians

Practice addresses (Care Compare)

507 S Douglas St
FL 3
El Segundo, CA 90245-4810
Phone (800) 985-5596

9731 Haines Canyon Ave
Tujunga, CA 91042-3312
Phone (818) 272-8260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008753CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Reset Medical Group PA Nurse Practitioner CurrentSince Mar 30, 2025 Accepting new patients
RPM Care Coordination, PC CurrentSince Oct 18, 2024 Accepting new patients
Pair Team Medical Group of California PC CurrentSince Nov 17, 2025 Accepting new patients
Onclick Healthcare Incorporated CurrentSince Dec 8, 2025 Accepting new patients
Pair Team Medical Group, P.a. CurrentSince Nov 17, 2025 Accepting new patients
Sleep Reset Medical Group of California PC Nurse Practitioner CurrentSince Feb 16, 2025 Accepting new patients
Noah Health Group LLC CurrentSince Dec 8, 2025 Accepting new patients
Aurora Home Health, Inc. PastSince May 1, 2019 Accepting new patients
Pasadena Hospital Association, LTD. PastSince Feb 16, 2019 Accepting new patients

Locations

4766 Park Granada
Ste 206B
Calabasas, CA 91302
Phone (818) 272-8260

507 S Douglas St
Fl 3
El Segundo, CA 90245

1100 Glendon Ave
Ste 1555
Los Angeles, CA 90024
Phone (669) 342-9449

1325 J St
Ste 1550
Sacramento, CA 95814
Phone (415) 320-7541

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

95 3rd St
San Francisco, CA 94103
Phone (414) 640-9090

2625 Townsgate Rd
Ste 330
Westlake Vlg, CA 91361
Phone (818) 272-8260

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ms_shaghnaz@landmarkhealth-direct.org
  • Direct secure messaging: shakeh.haghnazarian@682114225012740.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Aurora Home Health IncReseda, CA, CCN 559242 Home health agency Operational/Managerial Control May 1, 2019

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1255836904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 WINCHESTER AVE APT 6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011828",
            "telephone_number": "862-235-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 WINCHESTER AVE APT 6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011828",
            "telephone_number": "818-522-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGHNAZARIAN",
        "first_name": "SHAKEH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95008753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.