NPIMap

Individual provider Active NPI

Ani Serebrakian

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1629712906
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61102 Issued in CA
Practice address
1450 San Pablo St
Los Angeles, CA 90033-5331
Phone
(323) 442-9062
NPI assigned
Apr 23, 2022
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA61102 CA Primary

Addresses

Primary practice location

1450 San Pablo St
Los Angeles, CA 90033-5331

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Other practice location 1

1000 Magnolia Ave
Larkspur, CA 94939-1016
Phone (415) 490-6606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122003141 CA Practitioner - Physician Assistant 1759759731 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61102CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Oct 9, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 17, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Oct 9, 2022 Accepting new patients
University of California San Francisco CurrentSince Aug 17, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 17, 2023 Accepting new patients
University of California San Francisco CurrentSince Aug 17, 2023 Accepting new patients
Regents of the University of California CurrentSince Aug 17, 2023 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
University of California San Francisco Past Accepting new patients
Paramount Healthcare - a Professional Nursing Corporation PastSince Sep 3, 2025 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-6335

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: aserebrakian50912@direct-ucsfmedicalcenter.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1629712906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331",
            "telephone_number": "323-442-9062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Larkspur",
            "state": "CA",
            "postal_code": "949391016",
            "country_code": "US",
            "telephone_number": "415-490-6606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEREBRAKIAN",
        "first_name": "ANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-23",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.