Individual provider Active NPI

Nairi Bagramian, FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1477208460
Registry record updated Sep 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020028 Issued in CA
Practice address
1215 S Central Ave
Glendale, CA 91204-2503
Phone
(818) 241-1911
NPI assigned
Feb 17, 2022
Last updated
Sep 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95020028 CA Primary

Addresses

Primary practice location

1215 S Central Ave
Glendale, CA 91204-2503

Mailing address

1215 S Central Ave
Glendale, CA 91204-2503
Phone (818) 241-1911

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
I20220621002793 CA Practitioner - Nurse Practitioner 8628457769 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95020028CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Home Care MD Medical Group Family CurrentSince Jun 23, 2022 Accepting new patients
Advanced Practitioner Medical Group - a Professional Nursing Corp Family CurrentSince Jun 9, 2022 Accepting new patients

Locations

10570 Foothill Blvd
Ste 210
Rancho Cucamonga, CA 91730
Phone (909) 991-7577

100 N Barranca St
Ste 900J
West Covina, CA 91791
Phone (626) 377-7608

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": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1477208460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042503",
            "telephone_number": "818-241-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042503",
            "telephone_number": "818-241-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGRAMIAN",
        "first_name": "NAIRI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-09-11",
        "certification_date": "2022-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.