Organization Active NPI

Albert Baktanian MD Inc Apmc

  • Ophthalmology Physician
  • Glendale, CA
National Provider Identifier
1386954154
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A41358 Issued in CA
Legal business name
ALBERT BAKTANIAN MD INC APMC
Practice address
1030 S Glendale Ave
Suite 505
Glendale, CA 91205-5612
Phone
(818) 500-0888
Fax
(818) 500-4807
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Dr. Albert Baktanian, MDNPI 1336176072
Title
President
Phone
(818) 500-0888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A41358 CA Primary

Addresses

Primary practice location

1030 S Glendale Ave
Suite 505
Glendale, CA 91205-5612

Mailing address

1030 S Glendale Ave
Suite 505
Glendale, CA 91205-5612
Phone (818) 500-0888

Other identifiers 2

IdentifierTypeStateIssuer
A41358OtherCAMEDICAL LICENSE
00A413580MedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930073721 CA DME Supplier - Physician - Ophthalmology 5698989200 1 other NPI on this enrollment
Practice locations: Glendale, CA
O20101105000137 CA Part B Supplier - Clinic/Group Practice 5698989200 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

801 S Chevy Chase Dr
Ste 10
Glendale, CA 91205

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": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1386954154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "SUITE 505",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912055612",
            "telephone_number": "818-500-0888",
            "fax_number": "818-500-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "SUITE 505",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912055612",
            "telephone_number": "818-500-0888",
            "fax_number": "818-500-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT BAKTANIAN MD INC APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "BAKTANIAN",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-500-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A41358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A41358",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A413580",
            "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 Mar 7, 2014; 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.