Individual provider Active NPI

Garineh Martirossian Nersisyan, O.D

  • Optometrist
  • Calabasas, CA
National Provider Identifier
1396058129
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13970 Issued in CA
Practice address
4783 Commons Way
Suite C
Calabasas, CA 91302-3368
Phone
(818) 222-9465
Fax
(818) 222-9468
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13970 CA Primary

Addresses

Primary practice location

4783 Commons Way
Suite C
Calabasas, CA 91302-3368

Mailing address

4783 Commons Way
Suite C
Calabasas, CA 91302-3368
Phone (818) 222-9465

Other identifiers 1

IdentifierTypeStateIssuer
12142483OtherCACAQH

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000505 CA Practitioner - Optometry 8224225586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24305 Town Ctr Dr
Suite 160
Valencia, CA 91355-1347
Phone (661) 799-7464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13970CAMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Garineh M. Nersisyan, O.D., a Professional Optometric Corporation Optometrist CurrentSince Jun 24, 2022 Accepting new patients

Locations

24305 Town Center Dr
Ste 160
Valencia, CA 91355
Phone (661) 799-7464

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": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1396058129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4783 COMMONS WAY",
            "address_2": "SUITE C",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023368",
            "telephone_number": "818-222-9465",
            "fax_number": "818-222-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4783 COMMONS WAY",
            "address_2": "SUITE C",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023368",
            "telephone_number": "818-222-9465",
            "fax_number": "818-222-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERSISYAN",
        "first_name": "GARINEH",
        "middle_name": "MARTIROSSIAN",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12142483",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.