Mary Tuteryan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3160 E del Mar Blvd Ste 100
Pasadena, CA 91107-4649

Phone

(626) 398-6300

NPI assigned

Jul 2, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1306408034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 E DEL MAR BLVD STE 100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074649",
            "telephone_number": "626-398-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 E DEL MAR BLVD STE 100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074649",
            "telephone_number": "626-398-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12431 Erwin St",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916064508",
            "country_code": "US",
            "telephone_number": "818-624-1274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12431 Erwin St",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916064508",
            "country_code": "US",
            "telephone_number": "818-624-1274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6330 San Vicente Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485449",
            "country_code": "US",
            "telephone_number": "323-525-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUTERYAN",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Walter E Tyler
• Amber Lashan Tyner

• Physician Assistant in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.