Individual provider Active NPI

Galina Vardanyan, O.D.

  • Optometrist
  • Burbank, CA
National Provider Identifier
1467929265
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34144 Issued in CA
Practice address
2005 W Alameda Ave
Burbank, CA 91506-2932
Phone
(818) 476-4639
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34144 CA Primary

Addresses

Primary practice location

2005 W Alameda Ave
Burbank, CA 91506-2932

Mailing address

2005 W Alameda Ave
Burbank, CA 91506-2932
Phone (818) 476-4639

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
I20190220001205 CA Practitioner - Optometry 2769729474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2005 W Alameda Ave
Burbank, CA 91506-2932
Phone (818) 476-4639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Galina Vardanyan, O.D., Optometry Corporation Optometrist CurrentSince Jun 17, 2024 Accepting new patients
Boaz Eyewear Opt,Inc PastSince May 16, 2022 Accepting new patients
Paul Kim, O.D., a Professional Corporation Optometrist PastSince Oct 30, 2022 Accepting new patients

Locations

2005 W Alameda Ave
Burbank, CA 91506
Phone (818) 476-4639

Organizations & group practices 3

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": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1467929265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062932",
            "telephone_number": "818-476-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062932",
            "telephone_number": "818-476-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDANYAN",
        "first_name": "GALINA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.