Individual provider Active NPI

Jivan Melikian, M.D.

  • Cardiovascular Disease Physician
  • Glendale, CA
National Provider Identifier
1285705905
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A45112 Issued in CA
Practice address
1530 E Chevy Chase Dr
Suite 206
Glendale, CA 91206-4163
Phone
(818) 546-8644
Fax
(818) 546-2494
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A45112 CA
Cardiovascular Disease Physician 207RC0000X A45112 CA Primary
Interventional Cardiology Physician 207RI0011X A45112 CA

Addresses

Primary practice location

1530 E Chevy Chase Dr
Suite 206
Glendale, CA 91206-4163

Mailing address

1530 E Chevy Chase Dr
Suite 206
Glendale, CA 91206-4163
Phone (818) 546-8644

Other identifiers 1

IdentifierTypeStateIssuer
00A45112MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000872 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - General PracticePractitioner - Internal MedicinePractitioner - Peripheral Vascular Disease 5597744995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Peripheral Vascular Disease
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1530 E Chevy Chase Dr
Suite 206
Glendale, CA 91206-4190

Hospital & facility affiliations

  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239
  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45112CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jivan Melikian M D. Inc Cardiovascular Disease CurrentSince Jun 15, 1993 Accepting new patients
Hospital Physicians Medical Group, Inc. Cardiovascular Disease Past Accepting new patients

Locations

1530 E Chevy Chase Dr
Ste 206
Glendale, CA 91206
Phone (818) 244-3137

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1285705905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 206",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-546-8644",
            "fax_number": "818-546-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 206",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-546-8644",
            "fax_number": "818-546-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELIKIAN",
        "first_name": "JIVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45112",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A45112",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A45112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A45112",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.