Individual provider Active NPI

Stepan Kasimian, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Glendale, CA
National Provider Identifier
1720003619
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A77961 Issued in CA
Practice address
1101 East Broadway
Ste 201
Glendale, CA 91205-1396
Phone
(213) 361-7038
Fax
(818) 500-9272
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A77961 CA
Orthopaedic Surgery of the Spine Physician 207XS0117X A77961 CA Primary

Addresses

Primary practice location

1101 East Broadway
Ste 201
Glendale, CA 91205-1396

Mailing address

1101 East Broadway
Ste 201
Glendale, CA 91205-1396
Phone (213) 361-7038

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
I20050915000422 CA Practitioner - Orthopedic Surgery 3375576804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77961CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Haas Specialty Surgery Center Current Accepting new patients
Haas Wellness Center Current Accepting new patients
Broadway Surgery Specialists Orthopaedic Surgery Current Accepting new patients
Stepan Kasimian MD Inc Orthopaedic Surgery of the Spine Past Accepting new patients

Locations

1101 E Broadway
Ste 201
Glendale, CA 91205
Phone (213) 361-7038

Interoperability endpoints

  • Direct secure messaging: stepan.kasimian@1411.chartlogic.direct-ci.com

Organizations & group practices 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1720003619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 EAST BROADWAY",
            "address_2": "STE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051396",
            "telephone_number": "213-361-7038",
            "fax_number": "818-500-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 EAST BROADWAY",
            "address_2": "STE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051396",
            "telephone_number": "213-361-7038",
            "fax_number": "818-500-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIMIAN",
        "first_name": "STEPAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A77961",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A77961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.