Individual provider Active NPI

Ara A Poladian, M.D., F.A.C.O.G.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • North Hollywood, CA
National Provider Identifier
1457450439
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
A40162 Issued in CA
Practice address
10876 Riverside Dr
North Hollywood, CA 91602-2236
Phone
(818) 763-2992
Fax
(818) 763-6054
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A40162 CA
Obstetrics & Gynecology Physician 207V00000X A40162 CA
Reproductive Endocrinology Physician 207VE0102X A40162 CA
Gynecology Physician 207VG0400X A40162 CA
Surgery Physician 208600000X A40162 CA
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X A40162 CA Primary

Addresses

Primary practice location

10876 Riverside Dr
North Hollywood, CA 91602-2236

Mailing address

10876 Riverside Dr
North Hollywood, CA 91602-2236
Phone (818) 763-2992

Other identifiers 1

IdentifierTypeStateIssuer
8880117MedicaidCA

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
I20120530000409 CA Practitioner - Obstetrics/Gynecology 3375706427

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1457450439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10876 RIVERSIDE DR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022236",
            "telephone_number": "818-763-2992",
            "fax_number": "818-763-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10876 RIVERSIDE DR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022236",
            "telephone_number": "818-763-2992",
            "fax_number": "818-763-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLADIAN",
        "first_name": "ARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.O.G.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A40162",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A40162",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CA",
            "license": "A40162",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A40162",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A40162",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "A40162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8880117",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.