Individual provider Active NPI

Hrair Puzant Gulesserian, M.D.

  • Surgical Oncology Physician
  • San Jose, CA
National Provider Identifier
1689626301
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
A24341 Issued in CA
Practice address
393 Blossom Hill Road
Suite 310
San Jose, CA 95123-1653
Phone
(408) 578-5831
Fax
(408) 578-6076
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X A24341 CA Primary

Addresses

Primary practice location

393 Blossom Hill Road
Suite 310
San Jose, CA 95123-1653

Mailing address

393 Blossom Hill Road
Suite 310
San Jose, CA 95123-1653
Phone (408) 578-5831

Other identifiers 2

IdentifierTypeStateIssuer
00A24341MedicaidCA
00A243410MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040630000858 CA Practitioner - General Surgery 5496732265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24341CAMDChiropractor
A24341CAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H.P. Gulesserian, MD., Inc. Surgical Oncology CurrentSince Oct 11, 2012 Accepting new patients

Locations

393 Blossom Hill Rd
Ste 330
San Jose, CA 95123
Phone (408) 578-5831

393 Blossom Hill Rd
Ste 310
San Jose, CA 95123
Phone (408) 578-5831

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1689626301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL ROAD",
            "address_2": "SUITE 310",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231653",
            "telephone_number": "408-578-5831",
            "fax_number": "408-578-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL ROAD",
            "address_2": "SUITE 310",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231653",
            "telephone_number": "408-578-5831",
            "fax_number": "408-578-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULESSERIAN",
        "first_name": "HRAIR",
        "middle_name": "PUZANT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A24341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A24341",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A243410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.