Individual provider Active NPI

Shushanik Agaronyan, NP

  • Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1417806753
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95026819 Issued in CA
Practice address
13761 Victory Blvd
Van Nuys, CA 91401-2348
Phone
(818) 902-9000
NPI assigned
Jan 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 95026819 CA Primary

Addresses

Primary practice location

13761 Victory Blvd
Van Nuys, CA 91401-2348

Mailing address

13761 Victory Blvd
Van Nuys, CA 91401-2348
Phone (818) 902-9000

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
I20260220003931 CA Practitioner - Nurse Practitioner 0547741209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13761 Victory Blvd
van nuys, CA 91401-2348

14443 Titus St
Panorama City, CA 91402-5251

27574 Commerce Ctr Dr
Suite 232
Temecula, CA 92590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agari Home Health, LLC CurrentSince Oct 16, 2022 Accepting new patients
Nueva Vida Medical Center Inc Single Specialty CurrentSince Feb 1, 2026 Accepting new patients
Nueva Vida Medical Group Inc PastSince Feb 1, 2026 Accepting new patients

Locations

14443 Titus St
Panorama City, CA 91402
Phone (747) 777-3445

13761 Victory Blvd
Van Nuys, CA 91401
Phone (818) 203-1404

Organizations & group practices 3

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": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1417806753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13761 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012348",
            "telephone_number": "818-902-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13761 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012348",
            "telephone_number": "818-902-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARONYAN",
        "first_name": "SHUSHANIK",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.