Individual provider Active NPI

Boghos I. Yerevanian, M.D.

  • Psychiatry Physician
  • North Hills, CA
National Provider Identifier
1457458796
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C40853 Issued in CA
Practice address
16111 Plummer (116a)
Psychiatry Department BLDG 10
North Hills, CA 91343
Phone
(818) 891-7711
Fax
(818) 223-9277
NPI assigned
Sep 20, 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
Psychiatry Physician 2084P0800X C40853 CA Primary

Addresses

Primary practice location

16111 Plummer (116a)
Psychiatry Department BLDG 10
North Hills, CA 91343

Mailing address

23300 Park Hacienda
Calabasas, CA 91302-1715
Phone (818) 410-5398

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
I20051108000874 CA Practitioner - Psychiatry 1557389541 Practice locations: Encino, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16055 Ventura Blvd
Suite 645
Encino, CA 91436-2609
Phone (818) 907-9981

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C40853CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Karine Shakib, Psy.D., a Psychological Corporation Past Accepting new patients
Veterans Administration Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457458796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 PARK HACIENDA",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021715",
            "telephone_number": "818-410-5398",
            "fax_number": "818-223-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16111 PLUMMER (116A)",
            "address_2": "PSYCHIATRY DEPARTMENT BLDG 10",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "91343",
            "telephone_number": "818-891-7711",
            "fax_number": "818-223-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEREVANIAN",
        "first_name": "BOGHOS",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C40853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hills, CA

Sources for this page

Verify at the official NPI Registry.