Individual provider Active NPI

Ani Halabi Khroyan, O.D.

  • Optometrist
  • Glendale, CA
National Provider Identifier
1669584702
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12807 TPA Issued in CA
Practice address
413 E Glenoaks Blvd
Suite #B
Glendale, CA 91207-2013
Phone
(818) 230-0550
Fax
(818) 244-8175
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12807 TPA CA Primary

Addresses

Primary practice location

413 E Glenoaks Blvd
Suite #B
Glendale, CA 91207-2013

Mailing address

413 E Glenoaks Blvd
Suite #B
Glendale, CA 91207-2013
Phone (818) 230-0550

Other identifiers 2

IdentifierTypeStateIssuer
EA 696ZOtherCAMEDICARE PTAN INDIVIDUAL
EZ690AOtherCAMEDICARE GROUP PTAN

Other names 1

  • Ani Halabi Professional name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050801000884 CA Practitioner - Optometry 9234167164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

413 E Glenoaks Blvd
Suite B
Glendale, CA 91207-2013
Phone (818) 230-0550

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12807 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Center Ani Halabi OD Doctor of Optometry PC CurrentSince Oct 4, 2010 Accepting new patients
Duane Decroupet OD a PC Optometrist Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Glendale Optometric Center Optometrist PastSince Jul 10, 2007 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

413 E Glenoaks Blvd
#B
Glendale, CA 91207
Phone (818) 230-0550

413 E Glenoaks Blvd
Ste B
Glendale, CA 91207
Phone (818) 230-0550

1222 S Glendale Ave
Unit 3
Glendale, CA 91205
Phone (808) 750-5555

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1669584702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E GLENOAKS BLVD",
            "address_2": "SUITE #B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072013",
            "telephone_number": "818-230-0550",
            "fax_number": "818-244-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E GLENOAKS BLVD",
            "address_2": "SUITE #B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072013",
            "telephone_number": "818-230-0550",
            "fax_number": "818-244-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHROYAN",
        "first_name": "ANI",
        "middle_name": "HALABI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12807 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "EA 696Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "EZ690A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANI",
            "last_name": "HALABI",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.