Individual provider Active NPI

Lilit Javadian, OD

  • Optometrist
  • Glendale, CA
National Provider Identifier
1578041356
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34039TLG Issued in CA
Practice address
413 E Glenoaks Blvd Ste B
Glendale, CA 91207-2013
Phone
(818) 230-0550
NPI assigned
Aug 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34039TLG CA Primary

Addresses

Primary practice location

413 E Glenoaks Blvd Ste B
Glendale, CA 91207-2013

Mailing address

3108 Paddington Rd
Glendale, CA 91206-1355
Phone (818) 731-8018

Other practice location 1

735 S Figueroa St Ste 137
Los Angeles, CA 90017-2574
Phone (213) 612-0174

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926003916 CA Order and Referring Only - OptometryPractitioner - Optometry 1153672308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34039TLGCAMDOptometrist
34039CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Center Ani Halabi OD Doctor of Optometry PC PastSince Oct 4, 2010 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1578041356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 PADDINGTON RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912061355",
            "telephone_number": "818-731-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E GLENOAKS BLVD STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072013",
            "telephone_number": "818-230-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 S Figueroa St Ste 137",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900172574",
            "country_code": "US",
            "telephone_number": "213-612-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVADIAN",
        "first_name": "LILIT",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34039TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.