Individual provider Active NPI

Tina Tiffany Sarhadian, NP

  • Nurse Practitioner
  • La Crescenta, CA
National Provider Identifier
1619654092
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95025709 Issued in CA
Practice address
3028 Fairesta St
La Crescenta, CA 91214-2711
Phone
(818) 731-0932
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95025709 CA Primary

Addresses

Primary practice location

3028 Fairesta St
La Crescenta, CA 91214-2711

Mailing address

3028 Fairesta St
La Crescenta, CA 91214-2711
Phone (818) 731-0932

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
I20260602001090 CA Practitioner - Nurse Practitioner 4981010782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellsphere Health CareGroup PAC ID 7810482353, 3 clinicians

Practice addresses (Care Compare)

11856 Balboa Blvd
Suite 158
Granada Hills, CA 91344-2753
Phone (747) 366-0864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95025709CAMDNurse Practitioner

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Best Level Hospice IncEncino, CA, CCN B31753 Hospice W-2 Managing Employee
Operational/Managerial Control
Dec 20, 2024
Dec 20, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1619654092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 FAIRESTA ST",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142711",
            "telephone_number": "818-731-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 FAIRESTA ST",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142711",
            "telephone_number": "818-731-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARHADIAN",
        "first_name": "TINA",
        "middle_name": "TIFFANY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95025709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.