Individual provider Active NPI

Azaduhi Kalaydjian, CNM, WHNP-BC

  • Advanced Practice Midwife
  • Victorville, CA
National Provider Identifier
1619685633
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236326 Issued in CA
Practice address
16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone
(760) 241-8000
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 95023156 CA
Advanced Practice Midwife 367A00000X 236326 CA Primary

Addresses

Primary practice location

16850 Bear Valley Rd
Victorville, CA 92395-5794

Mailing address

10121 Memory Park Ave
Mission Hills, CA 91345-2726
Phone (818) 689-5120

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516001184 CA Practitioner - Certified Nurse Midwife (CNM) 6507222601 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Valley Medical Group IncGroup PAC ID 4880595875, 78 clinicians

Practice addresses (Care Compare)

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
95023156CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Medical Group, Inc. Current Accepting new patients
DHP of California Medical Group Inc CurrentSince May 22, 2023 Accepting new patients
Obhg California, P.C. CurrentSince Nov 1, 2024 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Feb 7, 2023 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Feb 7, 2023 Accepting new patients
Samir E. Hage, D.O., Inc. Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients

Locations

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

16850 Bear Valley Rd
Ste 203
Victorville, CA 92395

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: azaduhi.kalaydijian.p1@direct.dvmg.nextgenshare.com

Organizations & group practices 7

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1619685633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 MEMORY PARK AVE",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452726",
            "telephone_number": "818-689-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAYDJIAN",
        "first_name": "AZADUHI",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95023156",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.