Individual provider Active NPI

Meruzhan Kirakosyan, AGPCNP

  • Gerontology Nurse Practitioner
  • North Hollywood, CA
National Provider Identifier
1609768399
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95036168 Issued in CA
Practice address
12700 Blythe St
North Hollywood, CA 91605-2123
Phone
(818) 667-1161
NPI assigned
Jul 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95036168 CA Primary

Addresses

Primary practice location

12700 Blythe St
North Hollywood, CA 91605-2123

Mailing address

12700 Blythe St
North Hollywood, CA 91605-2123

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
I20260618001054 CA Practitioner - Nurse Practitioner 2567934706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Glendale, CA 91204
Phone (818) 262-0035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95036168CAMDGerontology Nurse Practitioner

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1609768399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 BLYTHE ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 BLYTHE ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052123",
            "telephone_number": "818-667-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRAKOSYAN",
        "first_name": "MERUZHAN",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95036168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.