Active NPI
Artine Kokshanian, M.D.
- Otolaryngology Physician
- Glendale, CA
National Provider Identifier
1336116862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- A30124
- Practice address
- 1030 S Glendale Ave
Suite 506
Glendale, CA 91205-5612 - Phone
- (818) 240-4283
- Fax
- (818) 240-4624
- NPI assigned
- Mar 2, 2006
- Reactivated
- Apr 5, 2006
- Last updated
- Sep 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | A30124 | CA | Primary |
Addresses
Primary practice location
1030 S Glendale Ave
Suite 506
Glendale, CA 91205-5612
Mailing address
1030 S Glendale Ave
Suite 506
Glendale, CA 91205-5612
Phone (818) 240-4283
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A301244 | Medicaid | CA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A30124 | CA | MD | Otolaryngology Physician |
| 30124 | CA | MD | Registered Respiratory Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- San Jose, CA
- NPI 1326312067
-
- Medical Specialty Clinic/Center
- Glendale, CA
- NPI 1447705876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1336116862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 S GLENDALE AVE",
"address_2": "SUITE 506",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912055612",
"telephone_number": "818-240-4283",
"fax_number": "818-240-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 S GLENDALE AVE",
"address_2": "SUITE 506",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912055612",
"telephone_number": "818-240-4283",
"fax_number": "818-240-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOKSHANIAN",
"first_name": "ARTINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2016-09-02",
"deactivation_date": "2006-03-25",
"reactivation_date": "2006-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "A30124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A301244",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.