Organization Active NPI

Gregory H Tchejeyan MD Inc

  • Specialist
  • Thousand Oaks, CA
National Provider Identifier
1376835330
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A55364 Issued in CA
Legal business name
GREGORY H TCHEJEYAN MD INC
Practice address
250 Lombard St Ste 1
Thousand Oaks, CA 91360-8208
Phone
(805) 495-3687
Fax
(805) 494-1828
NPI assigned
May 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Siuke Lili
Title
Manager
Phone
(805) 495-3687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A55364 CA Primary

Addresses

Primary practice location

250 Lombard St Ste 1
Thousand Oaks, CA 91360-8208

Mailing address

250 Lombard St Ste 1
Thousand Oaks, CA 91360-8208
Phone (805) 495-3687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110416000044 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 7618151606 Practice locations: Thousand Oaks, CA
O20120228000090 CA Part B Supplier - Clinic/Group Practice 7618151606 Receives reassigned benefits from 1 practitioner
Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

2100 Lynn Rd
Ste 115
Thousand Oaks, CA 91360
Phone (805) 379-2322

696 Hampshire Rd
Ste 100
Westlake Vlg, CA 91361
Phone (805) 413-7920

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1376835330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 LOMBARD ST STE 1",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608208",
            "telephone_number": "805-495-3687",
            "fax_number": "805-494-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LOMBARD ST STE 1",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608208",
            "telephone_number": "805-495-3687",
            "fax_number": "805-494-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY H TCHEJEYAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "LILI",
        "authorized_official_first_name": "SIUKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "805-495-3687"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A55364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.