Individual provider Active NPI

Nune Simonian, M.D.

  • Pediatrics Physician
  • Glendale, CA
National Provider Identifier
1720197932
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A55410 Issued in CA
Practice address
540 N Central Ave
#301
Glendale, CA 91203-3358
Phone
(818) 242-3916
Fax
(818) 242-4586
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A55410 CA Primary

Addresses

Primary practice location

540 N Central Ave
#301
Glendale, CA 91203-3358

Mailing address

540 N Central Ave
#301
Glendale, CA 91203-3358
Phone (818) 242-3916

Other identifiers 1

IdentifierTypeStateIssuer
00A554102MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55410CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Susanna Yerzinkian MD Pediatrics Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1720197932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N CENTRAL AVE",
            "address_2": "#301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033358",
            "telephone_number": "818-242-3916",
            "fax_number": "818-242-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N CENTRAL AVE",
            "address_2": "#301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033358",
            "telephone_number": "818-242-3916",
            "fax_number": "818-242-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIAN",
        "first_name": "NUNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A55410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A554102",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.