Individual provider Active NPI

Kevin Gary Galstyan, M.D.

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1396767471
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A87868 Issued in CA
Practice address
1500 S. Central Avenue
200
Glendale, CA 91204
Phone
(818) 637-7618
Fax
(818) 637-7616
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A87868 CA Primary

Addresses

Primary practice location

1500 S. Central Avenue
200
Glendale, CA 91204

Mailing address

1500 S. Central Avenue
200
Glendale, CA 91204
Phone (818) 637-7618

Other identifiers 1

IdentifierTypeStateIssuer
A87868OtherCACA MEDICAL LICENSE NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061209000043 CA Practitioner - Obstetrics/Gynecology 5991704538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 W Eulalia St
Glendale, CA 91204-2851
Phone (818) 502-4567

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87868CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Program of Glendale Memorial a Professional Corporation Current Accepting new patients
Kevin G. Galstyan M.D., Inc Obstetrics & Gynecology CurrentSince Aug 1, 2006 Accepting new patients

Locations

222 W Eulalia St
Ste 211
Glendale, CA 91204
Phone (818) 502-4567

1500 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 242-8916

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396767471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S. CENTRAL AVENUE",
            "address_2": "200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91204",
            "telephone_number": "818-637-7618",
            "fax_number": "818-637-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S. CENTRAL AVENUE",
            "address_2": "200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91204",
            "telephone_number": "818-637-7618",
            "fax_number": "818-637-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALSTYAN",
        "first_name": "KEVIN",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A87868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE NUMBER",
            "identifier": "A87868",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.