Active NPI
Andranik Vasilyan
- Family Medicine Physician
- Sonora, CA
National Provider Identifier
1497515464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A210915
- Practice address
- 193 Fairview LN
Sonora, CA 95370-4828 - Phone
- (209) 768-0977
- NPI assigned
- Mar 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A210915 | CA | Primary |
Addresses
Primary practice location
193 Fairview LN
Sonora, CA 95370-4828
Mailing address
193 Fairview LN
Sonora, CA 95370-4828
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241028001471 | CA | Order and Referring Only - Family Practice | 1355874405 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1497515464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 FAIRVIEW LN",
"city": "SONORA",
"state": "CA",
"postal_code": "953704828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "193 FAIRVIEW LN",
"city": "SONORA",
"state": "CA",
"postal_code": "953704828",
"telephone_number": "209-768-0977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASILYAN",
"first_name": "ANDRANIK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-19",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A210915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.