Andre Basmadzhyan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A18560 Issued in CA

Practice address

732 Mott St Ste 100-110
San Fernando, CA 91340-4237

Phone

(818) 963-5690

NPI assigned

Mar 20, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Fernando Community HospitalGroup PAC ID 7719298728, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFDBCA

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.

• San Fernando Community Hospital

  • Primary Care Clinic/Center
  • San Fernando, CA
  • NPI 1245669555

  Family Medicine

  Medicare reassignment Care Compare group NPD
• San Fernando Community Health Center

  • Clinic/Center
  • San Fernando, CA
  • NPI 1093151821
  NPD (past)
• Adena Medical Group LLC

  • Family Medicine Physician
  • Chillicothe, OH
  • NPI 1235468083
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1508307745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 MOTT ST STE 100-110",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404237",
            "telephone_number": "818-963-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 MOTT ST STE 100-110",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404237",
            "telephone_number": "818-963-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASMADZHYAN",
        "first_name": "ANDRE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A18560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joann Barajas
• Barbara Barcelona-Zito
• Sanan Bardekjian, D.C
• Danielle Barry
• Tiffany Ortiz Bartlett, PSY. D.
• Ethan Luke Batatan
• Paayal Desai Bedi
• Andrew Benavidez
• Joseph Berberabe, FNP-C
• Angel Lewis Bermudez

• Family Medicine Physician in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.
• 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.