Evlyn Avanessian, MD, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EVLYN AVANESSIAN, MD, INC

Practice address

3628 Foothill Blvd
La Crescenta, CA 91214-1724

Phone

(818) 296-9601

Fax

(818) 296-9602

NPI assigned

Jul 17, 2014

Organization subpart

No

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

Authorized official

Name

Evlyn Avanessian, MDNPI 1295020709

Title

MD

Phone

(818) 352-3146

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evlyn Avanessian, M.D

  • Family Medicine Physician
  • La Crescenta, CA
  • NPI 1295020709
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1457768731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141724",
            "telephone_number": "818-296-9601",
            "fax_number": "818-296-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141724",
            "telephone_number": "818-296-9601",
            "fax_number": "818-296-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVLYN AVANESSIAN, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "AVANESSIAN",
        "authorized_official_first_name": "EVLYN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "818-352-3146",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A127456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in La Crescenta, CA
• Providers in La Crescenta, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.