NPIMap

Individual provider Active NPI

Sipan Mathevosian, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1518499722
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A157785 Issued in CA
Practice address
757 Westwood PLZ Ste 1638
Los Angeles, CA 90095
Phone
(818) 309-3133
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X A157785 CA
Diagnostic Radiology Physician 2085R0202X A157785 CA Primary

Addresses

Primary practice location

757 Westwood PLZ Ste 1638
Los Angeles, CA 90095

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603000359 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4183014160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evsla Medical CorporationGroup PAC ID 2567824501, 3 clinicians

Practice addresses (Care Compare)

28049 Smyth Dr
Valencia, CA 91355-4023
Phone (661) 705-9706

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157785CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evsla Medical Corporation Vascular & Interventional Radiology CurrentSince Nov 30, 2025 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 1, 2022 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 1, 2022 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

2950 Sycamore Dr
Ste 200
Simi Valley, CA 93065
Phone (661) 705-9706

28049 Smyth Dr
Valencia, CA 91355
Phone (661) 705-9706

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1518499722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 1638",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "818-309-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEVOSIAN",
        "first_name": "SIPAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A157785",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A157785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.