Individual provider Active NPI

Harut Chris Boyadjian, NP

  • Family Nurse Practitioner
  • Valley Village, CA
National Provider Identifier
1346925500
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05230952 Issued in CA
Practice address
12660 Riverside Dr Ste 110
Valley Village, CA 91607-3430
Phone
(818) 761-1800
NPI assigned
Jun 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F05230952 CA Primary

Addresses

Primary practice location

12660 Riverside Dr Ste 110
Valley Village, CA 91607-3430

Mailing address

12660 Riverside Dr Ste 110
Valley Village, CA 91607-3430
Phone (818) 761-1800

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
I20250211002033 CA Practitioner - Nurse Practitioner 3274063987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F05230952CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Studio City Urgent Care and Medical Center CurrentSince Dec 6, 2024 Accepting new patients

Locations

12660 Riverside Dr
Ste 110
Valley Village, CA 91607
Phone (818) 761-1800

Organizations & group practices 1

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": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1346925500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR STE 110",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073430",
            "telephone_number": "818-761-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR STE 110",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073430",
            "telephone_number": "818-761-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYADJIAN",
        "first_name": "HARUT",
        "middle_name": "CHRIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F05230952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

Verify at the official NPI Registry.