Individual provider Active NPI

Luiza Kazaryan, NP

  • Family Nurse Practitioner
  • Lake Balboa, CA
National Provider Identifier
1538728431
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011817 Issued in CA
Practice address
6858 McLennan Ave
Lake Balboa, CA 91406-4529
Phone
(818) 903-0521
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95011817 CA Primary

Addresses

Primary practice location

6858 McLennan Ave
Lake Balboa, CA 91406-4529

Mailing address

6858 McLennan Ave
Lake Balboa, CA 91406-4529
Phone (818) 903-0521

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
I20200102001896 CA Practitioner - Nurse Practitioner 4880028638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedar Springs Hospitalist Medical Group IncGroup PAC ID 6406199868, 26 clinicians

Practice addresses (Care Compare)

1420 S Central Ave
Glendale, CA 91204-2508
Phone (818) 502-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95011817CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Springs Hospitalist Medical Group, Inc. CurrentSince Nov 3, 2019 Accepting new patients

Locations

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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 1

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1538728431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6858 MCLENNAN AVE",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064529",
            "telephone_number": "818-903-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6858 MCLENNAN AVE",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064529",
            "telephone_number": "818-903-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZARYAN",
        "first_name": "LUIZA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Balboa, CA

Sources for this page

Verify at the official NPI Registry.