Organization Active NPI

Pilossyan Medical Center Inc

  • Internal Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1457543076
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51303 Issued in CA
Legal business name
PILOSSYAN MEDICAL CENTER INC
Practice address
13321 Victory Blvd
Van Nuys, CA 91401-1832
Phone
(818) 780-0101
Fax
(818) 780-8017
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Dr. Vagharshak Mikhael Pilossyan, MDNPI 1467530121
Title
Officer
Phone
(818) 780-0101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A51303 CA Primary

Addresses

Primary practice location

13321 Victory Blvd
Van Nuys, CA 91401-1832

Mailing address

13321 Victory Blvd
Van Nuys, CA 91401-1832
Phone (818) 780-0101

Other identifiers 1

IdentifierTypeStateIssuer
00A513031MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000639 CA Part B Supplier - Clinic/Group Practice 8022105964 Receives reassigned benefits from 1 practitioner
Practice locations: Van Nuys, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0914358Pilossyan Medical Center Laboratory13321 Victory Blvd, Van Nuys, CA 91401Certificate of waiverApr 25, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1457543076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13321 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011832",
            "telephone_number": "818-780-0101",
            "fax_number": "818-780-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13321 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011832",
            "telephone_number": "818-780-0101",
            "fax_number": "818-780-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILOSSYAN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "PILOSSYAN",
        "authorized_official_first_name": "VAGHARSHAK",
        "authorized_official_middle_name": "MIKHAEL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "818-780-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A513031",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.