Individual provider Active NPI

Ginney Mary Beladjian, MSN, FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1710670641
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025345 Issued in CA
Practice address
1505 Wilson Ter Ste 340
Glendale, CA 91206-4072
Phone
(818) 543-7574
Fax
(818) 956-7609
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025345 CA Primary

Addresses

Primary practice location

1505 Wilson Ter Ste 340
Glendale, CA 91206-4072

Mailing address

1505 Wilson Ter Ste 340
Glendale, CA 91206-4072
Phone (818) 543-7574

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
I20231011000069 CA Practitioner - Nurse Practitioner 1052766003 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hematology Oncology Centers Inc CurrentSince Oct 10, 2023 Accepting new patients

Locations

1505 Wilson Ter
Ste 340
Glendale, CA 91206
Phone (818) 247-5440

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": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1710670641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER STE 340",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064072",
            "telephone_number": "818-543-7574",
            "fax_number": "818-956-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER STE 340",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064072",
            "telephone_number": "818-543-7574",
            "fax_number": "818-956-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELADJIAN",
        "first_name": "GINNEY",
        "middle_name": "MARY",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.