NPIMap

Individual provider Active NPI

Kristine Astvatsaturyan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Orange, CA
National Provider Identifier
1366880692
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A139202 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8888
NPI assigned
Jun 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A139202 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A139202 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-8888

Other practice location 1

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-6941

Other practice location 2

319 S Brand Blvd
Glendale, CA 91204-1701
Phone (818) 468-1871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170808002546 CA Practitioner - Pathology 9436165834 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Regents of the University of California 40 clinicians
Complete Care Community Health Center, Inc 45 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033-3110
Phone (323) 266-6700

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A139202CAMDGeneral Practice Physician

Practice roles (12 of 13)

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Jul 1, 2017 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Aug 6, 2019 Accepting new patients
County of Los Angeles Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2024 Accepting new patients
County of Los Angeles CurrentSince Jul 1, 2017 Accepting new patients
Regents of the University of California Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2024 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Aug 6, 2019 Accepting new patients
University of California Irvine Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1145 W Redondo Beach Blvd
Gardena, CA 90247
Phone (310) 532-4200

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 266-6700

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kristine.astvatsaturyanmd.p1@direct.ccchcenter.nextgenshare.com

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 2

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": "1370736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1366880692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Beverly Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-6941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 S Brand Blvd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912041701",
            "country_code": "US",
            "telephone_number": "818-468-1871",
            "fax_number": "818-240-0038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASTVATSATURYAN",
        "first_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-09",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A139202",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A139202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.