Individual provider Active NPI

Hripsime Shirvanian, O.D.

  • Optometrist
  • South Pasadena, CA
National Provider Identifier
1275784118
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13564 Issued in CA
Practice address
1024 Mission St
Suite B
South Pasadena, CA 91030-3164
Phone
(626) 460-6022
Fax
(626) 460-6024
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13564 CA Primary

Addresses

Primary practice location

1024 Mission St
Suite B
South Pasadena, CA 91030-3164

Mailing address

1024 Mission St
Suite B
South Pasadena, CA 91030-3164
Phone (626) 460-6022

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000130 CA Practitioner - Optometry 9436210358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jaime Chan OD a Professional Corporation Optometrist CurrentSince May 7, 2024 Accepting new patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1275784118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 MISSION ST",
            "address_2": "SUITE B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303164",
            "telephone_number": "626-460-6022",
            "fax_number": "626-460-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 MISSION ST",
            "address_2": "SUITE B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303164",
            "telephone_number": "626-460-6022",
            "fax_number": "626-460-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRVANIAN",
        "first_name": "HRIPSIME",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.