Individual provider Active NPI

Diana Akhverdyan, AGNP

  • Adult Health Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1669178661
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95024109 Issued in CA
Practice address
4955 Van Nuys Blvd Ste 308
Van Nuys, CA 91403-1811
Phone
(818) 259-7070
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95024109 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 308
Van Nuys, CA 91403-1811

Mailing address

4955 Van Nuys Blvd Ste 308
Van Nuys, CA 91403-1811
Phone (818) 259-7070

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
I20240701003725 CA Practitioner - Nurse Practitioner 0244694040 Reassigns benefits to 2 organizations

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
Health Lync Medical Group IncGroup PAC ID 4587109913, 8 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone (818) 387-6114

Hospital & facility affiliations

  • Restart Home Health Care Inc Home health agency, La Crescenta, CA, CCN 757784

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95024109CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idyllic Home Health Services CurrentSince Jan 1, 2022 Accepting new patients
Derderyan Medical Group Inc. CurrentSince May 1, 2024 Accepting new patients
Health Lync Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

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
Idyllic Home Health ServicesBurbank, CA, CCN 757671 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Jan 1, 2022
Jan 1, 2022
Jan 1, 2022
Jan 1, 2022

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 3

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.

Hospital & facility affiliations 1

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1669178661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 308",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914031811",
            "telephone_number": "818-259-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 308",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914031811",
            "telephone_number": "818-259-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHVERDYAN",
        "first_name": "DIANA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95024109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.