Organization Active NPI

Alexander G Gevorgyan MD Inc

Doing business as Neurospine Centers

  • Medical Specialty Clinic/Center
  • Glendale, CA
National Provider Identifier
1699289660
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A133154 Issued in CA
Legal business name
ALEXANDER G GEVORGYAN MD INC
Doing business as
Neurospine Centers
Practice address
1332 S Glendale Ave
Glendale, CA 91205-3349
Phone
(818) 649-9232
Fax
(818) 696-0922
NPI assigned
Nov 28, 2017
Last updated
Nov 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Dr. Alexander G Gevorgyan, MDNPI 1346504628
Title
Ceo - Physician
Phone
(818) 649-9232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A133154 CA Primary

Addresses

Primary practice location

1332 S Glendale Ave
Glendale, CA 91205-3349

Mailing address

1332 S Glendale Ave
Glendale, CA 91205-3349
Phone (818) 649-9232

Other practice location 1

1451 E Chevy Chase Dr Ste 201
Glendale, CA 91206-4056
Phone (818) 265-2245

Other names 1

  • Neurospine Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180109001632 CA Part B Supplier - Clinic/Group Practice 0244599785 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Glendale, CA; Santa Clarita, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2166541Alexander G Gevorgyan, MD Inc1332 South Glendale Avenue, Glendale, CA 91205Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1699289660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053349",
            "telephone_number": "818-649-9232",
            "fax_number": "818-696-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053349",
            "telephone_number": "818-649-9232",
            "fax_number": "818-696-0922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 E Chevy Chase Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912064056",
            "country_code": "US",
            "telephone_number": "818-265-2245",
            "fax_number": "877-575-9782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALEXANDER G GEVORGYAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "GEVORGYAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO - PHYSICIAN",
        "authorized_official_telephone_number": "818-649-9232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A133154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurospine Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.