Active NPI
Hratch Demirjian, D.P.M.
- Podiatrist
- Covina, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3993
- Practice address
- 1257 W San Bernardino Rd
Covina, CA 91722-3509 - Phone
- (626) 331-7391
- Fax
- (626) 339-0613
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E3993 | CA | Primary |
Addresses
Primary practice location
1257 W San Bernardino Rd
Covina, CA 91722-3509
Mailing address
PO Box 1980
Covina, CA 91722-0980
Phone (626) 331-7391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00039930 | Medicaid | CA |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1257 W San Bernardino Rd
Covina, CA 91722-3509
Phone (626) 331-7391
3235 E Colorado Blvd
Suite 102
Pasadena, CA 91107-3838
Phone (626) 859-2249
Hospital & facility affiliations
- Emanate Health Inter-Community Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 114 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 529 |
| Removal or shaving of skin growth | 533 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E3993 | CA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hara Podiatrists' Group, Inc. | Podiatrist | Current | Accepting new patients |
| Physicians of Southern California Inc | Current | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients |
Locations
1257 W San Bernardino Rd
Covina, CA 91722
Phone (626) 331-7391
1624 S Grand Ave
Glendora, CA 91740
Phone (626) 859-2249
1304 W Holt Blvd
Ste A
Ontario, CA 91762
Phone (626) 859-2249
3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249
3235 E Colorado Blvd
Pasadena, CA 91107
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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 and National Provider Directory roles.
-
- Podiatrist
- Covina, CA
- NPI 1194733204
-
- Multi-Specialty Clinic/Center
- Ontario, CA
- NPI 1710587670
-
- General Acute Care Hospital
- West Covina, CA
- NPI 1063441293
-
- General Acute Care Hospital
- Covina, CA
- NPI 1982629440
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Covina, CA
- NPI 1063441293
-
- Psychiatric Hospital Unit
- Covina, CA
- NPI 1215063151
-
- General Acute Care Hospital
- Covina, CA
- NPI 1982629440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1265440366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1980",
"city": "COVINA",
"state": "CA",
"postal_code": "917220980",
"telephone_number": "626-331-7391",
"fax_number": "626-339-0613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1257 W SAN BERNARDINO RD",
"city": "COVINA",
"state": "CA",
"postal_code": "917223509",
"telephone_number": "626-331-7391",
"fax_number": "626-339-0613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMIRJIAN",
"first_name": "HRATCH",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E3993",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00039930",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.
- 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.