Individual provider Active NPI

Astgek Gabriyelyan

  • Nurse Practitioner
  • North Hollywood, CA
National Provider Identifier
1497536874
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95026081 Issued in CA
Practice address
6237 Kraft Ave
North Hollywood, CA 91606-4123
Phone
(818) 644-9035
NPI assigned
Oct 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 95026081 CA Primary

Addresses

Primary practice location

6237 Kraft Ave
North Hollywood, CA 91606-4123

Mailing address

6237 Kraft Ave
North Hollywood, CA 91606-4123
Phone (818) 644-9035

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20240419003268 CA Practitioner - Nurse Practitioner 2961841127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

26877 Tourney Rd
Santa Clarita, CA 91355-1846
Phone (888) 778-5000

8250 Woodman Ave
Panorama City, CA 91402-5427
Phone (818) 375-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 28, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 28, 2024 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients

Locations

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Trinity Home Health Care IncVan Nuys, CA, CCN 559281 Home health agency W-2 Managing Employee Apr 1, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1497536874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6237 KRAFT AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064123",
            "telephone_number": "818-644-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6237 KRAFT AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064123",
            "telephone_number": "818-644-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIYELYAN",
        "first_name": "ASTGEK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2024-05-07",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.