Individual provider Active NPI

David Petrosyan, FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1376346031
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95034545 Issued in CA
Practice address
643 Arden Ave
Glendale, CA 91202-4018
Phone
(818) 404-0499
NPI assigned
Mar 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 95034545 CA Primary

Addresses

Primary practice location

643 Arden Ave
Glendale, CA 91202-4018

Mailing address

643 Arden Ave
Glendale, CA 91202-4018
Phone (818) 404-0499

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
I20251211003706 CA Practitioner - Nurse Practitioner 8628562154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6444 San Fernando Rd
Suite 5690
Glendale, CA 91201-5079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95034545CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mehrdad Kevin Ariani MD Inc CurrentSince Dec 1, 2025 Accepting new patients
Jahandar Reza Saleh MD Inc CurrentSince Dec 1, 2025 Accepting new patients

Locations

18350 Roscoe Blvd
Ste 400
Northridge, CA 91325
Phone (818) 678-4900

Interoperability endpoints

  • Direct secure messaging: david.petrosyan@557989766037508.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1376346031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 ARDEN AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024018",
            "telephone_number": "818-404-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 ARDEN AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024018",
            "telephone_number": "818-404-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSYAN",
        "first_name": "DAVID",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.