Ava Khosraviani, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

248462 Issued in MA

Practice address

191 S Buena Vista St
Suite 475
Burbank, CA 91505-4554

Phone

(818) 842-8000

Fax

(818) 842-3208

NPI assigned

Nov 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Dermatology

Education

JS Weill Medical College, Cornell University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ak Derm CorpGroup PAC ID 3678806882, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ak Derm Corp

  dba skinwell dermatology

  • Dermatology Physician
  • Encino, CA
  • NPI 1013475805
  Medicare reassignment Care Compare group NPD Authorized official
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  NPD (past)
• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• Dignity Health

  dba St. Joseph's Hospital and Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1982733655
  NPD (past)

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1578717401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W OLYMPIC BLVD",
            "address_2": "SUITE 171",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113561",
            "telephone_number": "818-842-8000",
            "fax_number": "818-842-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "SUITE 475",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "818-842-8000",
            "fax_number": "818-842-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVIANI",
        "first_name": "AVA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "248462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafi Khobiarian, PHARMD
• Sareen Hacopians Khodabakhsh
• Akbar Khorshidi, DDS
• Shayesteh Rostamkolaei Khosh, DDS
• Christopher Khachik Khoshoryan, MD
• Soodabeh Khosropur, AMFT
• Sarkis Khotsuryan
• Arpine Khrchayan
• Anita Khudanyan
• Artyom Khurshudyan, MD

• Dermatology Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.