Individual provider Active NPI

Paul B Kouyoumjian, MD

  • Ophthalmology Physician
  • Glendale, CA
National Provider Identifier
1467654061
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A116329 Issued in CA
Practice address
500 N Central Ave Ste 400
Glendale, CA 91203-1928
Phone
(818) 956-1010
Fax
(818) 543-6083
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A116329 CA Primary

Addresses

Primary practice location

500 N Central Ave Ste 400
Glendale, CA 91203-1928

Mailing address

18546 Roscoe Blvd Ste 200
Northridge, CA 91324-5453
Phone (818) 993-1112

Other practice location 1

18546 Roscoe Blvd Ste 200
Northridge, CA 91324-5453
Phone (818) 993-1112

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
I20111208000222 CA Practitioner - Ophthalmology 9436274941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

18040 Sherman Way
Suite 205
Reseda, CA 91335-4656
Phone (818) 993-1112

500 N Central Ave
Suite 400
Glendale, CA 91203-1928
Phone (818) 208-6056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116329CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James McCaffery MD a Professional Corp Ophthalmology CurrentSince Jan 26, 2015 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 8, 2024 Accepting new patients
Usc Care Medical Group, Inc Ophthalmology CurrentSince Feb 8, 2024 Accepting new patients
Paul B Kouyoumjian, MD Inc. Ophthalmology CurrentSince Feb 1, 2021 Accepting new patients
Usc University Hospital, Inc. PastSince Feb 1, 2021 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

500 N Central Ave
Ste 100
Glendale, CA 91203
Phone (818) 538-5152

500 N Central Ave
Ste 400
Glendale, CA 91203
Phone 8184765107201

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Ste 4400
Los Angeles, CA 90033

18040 Sherman Way
Ste 205
Reseda, CA 91335
Phone (818) 993-1112

14124 Foothill Blvd
Sylmar, CA 91342
Phone (818) 364-8181

Organizations & group practices 5

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1467654061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18546 ROSCOE BLVD STE 200",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245453",
            "telephone_number": "818-993-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CENTRAL AVE STE 400",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031928",
            "telephone_number": "818-956-1010",
            "fax_number": "818-543-6083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18546 Roscoe Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913245453",
            "country_code": "US",
            "telephone_number": "818-993-1112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUYOUMJIAN",
        "first_name": "PAUL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A116329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.