Individual provider Active NPI

Asya Damatian, PA

  • Medical Physician Assistant
  • Canoga Park, CA
National Provider Identifier
1467919753
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
22030 Sherman Way Ste 101
Canoga Park, CA 91303-1844
Phone
(818) 312-9101
NPI assigned
Feb 22, 2019
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X CA Primary

Addresses

Primary practice location

22030 Sherman Way Ste 101
Canoga Park, CA 91303-1844

Mailing address

22001 Mayall St
Chatsworth, CA 91311-2822
Phone (818) 974-1590

Other practice location 1

3240 Fort Rd
Toppenish, WA 98948-9562
Phone (818) 974-1590

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917003103 CA Practitioner - Physician Assistant 5991134165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57290CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New Day Institute Past Accepting new patients
Karma TMS PC PastSince May 29, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1467919753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 MAYALL ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112822",
            "telephone_number": "818-974-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22030 SHERMAN WAY STE 101",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031844",
            "telephone_number": "818-312-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 Fort Rd",
            "address_purpose": "LOCATION",
            "city": "Toppenish",
            "state": "WA",
            "postal_code": "989489562",
            "country_code": "US",
            "telephone_number": "818-974-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMATIAN",
        "first_name": "ASYA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

Verify at the official NPI Registry.