Individual provider Active NPI

Manvel Michael Mazmanyan, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1619015195
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83571 Issued in CA
Practice address
1220 S Central Ave Ste 205
Glendale, CA 91204-3815
Phone
(818) 247-7677
NPI assigned
Feb 5, 2007
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83571 CA Primary

Addresses

Primary practice location

1220 S Central Ave Ste 205
Glendale, CA 91204-3815

Mailing address

1220 S Central Ave Ste 205
Glendale, CA 91204-3815
Phone (818) 247-7677

Other identifiers 1

IdentifierTypeStateIssuer
00A835710MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000867 CA Practitioner - General PracticePractitioner - Other (Physician) 9032177910 Reassigns benefits to 1 organization
Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1220 S Central Ave
Suite 205
Glendale, CA 91204-3815
Phone (818) 247-7677

333 E Magnolia Blvd
Suite 103
Burbank, CA 91502-1198
Phone (818) 848-1555

511 Western Ave
Glendale, CA 91201-2870
Phone (818) 240-5588

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.43 of 100Reported as individual
Quality
74.87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A83571CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Razmik Ohanjanian MD Inc Current Accepting new patients
Comcare Primary Medical Group a California General Partnership Family Medicine CurrentSince Sep 4, 2016 Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Sukiasyan Psychological Services Inc Past Accepting new patients

Locations

333 E Magnolia Blvd
Ste 103
Burbank, CA 91502
Phone (747) 283-1797

1030 S Glendale Ave
Ste 304
Glendale, CA 91205
Phone (818) 291-4041

1220 S Central Ave
Ste 205
Glendale, CA 91204
Phone (818) 247-7677

511 Western Ave
Glendale, CA 91201
Phone (818) 240-5588

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: manvelmazmanyanmd@mmm-ca.direct.office.nextgen.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1619015195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043815",
            "telephone_number": "818-247-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043815",
            "telephone_number": "818-247-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZMANYAN",
        "first_name": "MANVEL",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A835710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.