Individual provider Active NPI

Taline Grace Krikorian, PA-C

  • Medical Physician Assistant
  • Irvine, CA
National Provider Identifier
1295050920
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20866 Issued in CA
Practice address
3345 Michelson Dr Ste 100
Irvine, CA 92612-0693
Phone
(855) 229-6460
Fax
(503) 893-6847
NPI assigned
Apr 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61119226 WA
Physician Assistant 363A00000X PA20866 CA
Physician Assistant 363A00000X PA61119226 WA
Medical Physician Assistant 363AM0700X PA20866 CA Primary

Addresses

Primary practice location

3345 Michelson Dr Ste 100
Irvine, CA 92612-0693

Mailing address

400 W California Ave Unit 110
Glendale, CA 91203-2925

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
I20140612001535 CA Practitioner - Physician Assistant 1557585510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-6049

503 S Buena Vista St
Suite 101
Burbank, CA 91505-4809
Phone (818) 869-7630

Hospital & facility affiliations

  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20866CAMDPhysician Assistant
PA61119226WAMDPhysician Assistant
20866CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Nov 3, 2019 Accepting new patients
Providence Facey Medical Foundation CurrentSince Nov 3, 2019 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

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.

Hospital & facility affiliations 1

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": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1295050920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CALIFORNIA AVE UNIT 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 MICHELSON DR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926120693",
            "telephone_number": "855-229-6460",
            "fax_number": "503-893-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIKORIAN",
        "first_name": "TALINE",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61119226",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20866",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61119226",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.