Kristina Vartanian, NP
Individual provider Active NPI Nurse Practitioner · Long Beach, CA
NPI 1609599562 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1609599562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 95022779 (CA)
- Practice address
- 1050 Linden Ave
Long Beach, CA 90813-3321 - Phone
- (562) 491-9000
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221229001132 | CA | Practitioner - Nurse Practitioner | 6002286408 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Partners, a Medical Group, Inc. | Current |
Accepting new patients | |
| Prohealth Partners, a Medical Group | Current | Accepting new patients | |
| Prohealth Partners a Medical Group Inc | Current |
Accepting new patients |
Locations
1760 Termino Ave
Ste 214
Long Beach, CA 90804
Phone (562) 595-4718
1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000
1760 Termino Ave
Ste G18
Long Beach, CA 90804
Phone (562) 494-6700
File 54567
Los Angeles, CA 90074
Phone (310) 491-9060
4201 Torrance Blvd
Ste 350
Torrance, CA 90503
Phone (310) 540-5494
4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95022779 | CA | Yes |
Addresses
Primary practice location
1050 Linden Ave
Long Beach, CA 90813-3321
Mailing address
1760 Termino Ave Ste G18
Long Beach, CA 90804-2169
Other practice location 1
5750 Downey Ave
Lakewood, CA 90712-1405
Phone (562) 531-2550
Other providers in Long Beach, CA
- Joel Vargeese
- Joshua Varghese
- Malena Varillas
- Ishita Kothari Varma
- Namrata Varma
- Anna Varughese
- Karina Vasconcelos
- Emmanuel Constantine Vasilomanolakis
- Albert Vasquez
- Blanca Cristina Vasquez
All providers in Long Beach, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.