Individual provider Active NPI

Paul Kaloostian, MD

  • Neurological Surgery Physician
  • Pasadena, CA
National Provider Identifier
1497894430
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A97161 Issued in CA
Practice address
960 E Green St Ste 320
Pasadena, CA 91106-2401
Phone
(323) 633-5419
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X D73081 MD
Neurological Surgery Physician 207T00000X A97161 CA Primary

Addresses

Primary practice location

960 E Green St Ste 320
Pasadena, CA 91106-2401

Mailing address

2645 N Vermont Ave
Los Angeles, CA 90027-1244
Phone (323) 633-5419

Other identifiers 1

IdentifierTypeStateIssuer
055636000MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150217001056 CA Practitioner - Neurosurgery 0446414726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97161CAMDNeurological Surgery Physician
D73081MDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs Corona Inc Past Accepting new patients
Johns Hopkins University Neurological Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Organizations & group practices 4

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1497894430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900271244",
            "telephone_number": "323-633-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST STE 320",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062401",
            "telephone_number": "323-633-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOOSTIAN",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "D73081",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A97161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055636000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.