Individual provider Active NPI

Harout Khanjian, O.D.

  • Optometrist
  • Van Nuys, CA
National Provider Identifier
1467878249
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 14869 TLG Issued in CA
Practice address
14624 Sherman Way
#204
Van Nuys, CA 91405-2241
Phone
(818) 780-2020
Fax
(818) 561-3661
NPI assigned
Mar 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 14869 TLG CA Primary

Addresses

Primary practice location

14624 Sherman Way
#204
Van Nuys, CA 91405-2241

Mailing address

14624 Sherman Way
#204
Van Nuys, CA 91405-2241
Phone (818) 780-2020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140722002741 CA Practitioner - Optometry 3072739374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14624 Sherman Way
Suite 204
Van Nuys, CA 91405-2287
Phone (626) 641-0448

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 14869 TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
California Eye Center Optometry Inc Optometrist CurrentSince Jun 2, 2014 Accepting new patients

Locations

1030 S Glendale Ave
Ste 401
Glendale, CA 91205
Phone (818) 507-4340

14624 Sherman Way
Ste 204
Van Nuys, CA 91405
Phone (626) 641-0448

Organizations & group practices 1

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": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1467878249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "#204",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-780-2020",
            "fax_number": "818-561-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "#204",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-780-2020",
            "fax_number": "818-561-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANJIAN",
        "first_name": "HAROUT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-17",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 14869 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.