Nickolay T. Teophilov, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

A55038 Issued in CA

Practice address

222 W Eulalia St
Suite 301
Glendale, CA 91204-2849

Phone

(310) 472-0171

Fax

(310) 472-0171

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134159320
  NPD

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1710058987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 ROSCOMARE RD",
            "address_2": "B-8",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "310-472-0171",
            "fax_number": "310-472-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEOPHILOV",
        "first_name": "NICKOLAY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A55038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A550380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carine Njweng Tende, NP
• Tender Touch Hospice Care
• Tenderhearted Hospice
• Danielle Tenette
• Teni Minaeian Chiropractic Inc
• Ter Poghossian Dental Corporation
• Vartan Ter Poghossian, D.D.S.
• Levon Ter-Bagdasarian, ANP-C
• Armine Ter-Barseghyan, PA-C
• Armine Ter-Grigoryan

• Rheumatology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.