Chevy Chase Ambulatory Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

550000021 Issued in CA

Legal business name

CHEVY CHASE AMBULATORY CENTER LP

Practice address

801 S Chevy Chase Dr
Suite #106
Glendale, CA 91205-4431

Phone

(818) 265-2275

Fax

(818) 649-1034

NPI assigned

Jan 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Raffi Sarkissian

Title

Administrator

Phone

(818) 265-2227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Chevy Chase Ambulatory Center L PCCN 05C0001724

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1497733661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR",
            "address_2": "SUITE #106",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054431",
            "telephone_number": "818-265-2275",
            "fax_number": "818-649-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR",
            "address_2": "SUITE #106",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054431",
            "telephone_number": "818-265-2275",
            "fax_number": "818-649-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEVY CHASE AMBULATORY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "SARKISSIAN",
        "authorized_official_first_name": "RAFFI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-265-2227",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.