Individual provider Active NPI

Mariam Sargsyan, MD

  • Family Medicine Physician
  • Chino, CA
National Provider Identifier
1316436355
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A154034 Issued in CA
Practice address
5451 Walnut Ave
Chino, CA 91710-2609
Phone
(909) 464-8623
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A154034 CA Primary

Addresses

Primary practice location

5451 Walnut Ave
Chino, CA 91710-2609

Mailing address

1600 N Rose Ave
Oxnard, CA 93030-3722
Phone (805) 988-2505

Other practice location 1

1600 N Rose Ave
Oxnard, CA 93030-3722
Phone (805) 988-2505

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20200730001316 CA Practitioner - Family Practice 2062837628 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8001 Ventura Canyon Ave
Panorama City, CA 91402-6312
Phone (818) 375-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154034CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J M Geiss DO Apc Family Medicine CurrentSince Jun 15, 2020 Accepting new patients
Inpatient Specialists of California, PC Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Anaheim Urgent Care, Inc. CurrentSince Apr 18, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Anaheim Urgent Care, Inc. Family Medicine Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 6, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 6, 2024 Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Apr 18, 2022 Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

8001 Ventura Canyon Ave
Panorama City, CA 91402
Phone (818) 375-2028

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

23341 Mulholland Dr
Woodland Hills, CA 91364
Phone (818) 637-0048

Organizations & group practices 8

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": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1316436355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N ROSE AVE",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303722",
            "telephone_number": "805-988-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-464-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Rose Ave",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930303722",
            "country_code": "US",
            "telephone_number": "805-988-2505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARGSYAN",
        "first_name": "MARIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2024-12-30",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A154034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.