Individual provider Active NPI

Victoria Gleichman, PA-C

  • Physician Assistant
  • Burbank, CA
National Provider Identifier
1770977340
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55208 Issued in CA
Practice address
201 S Buena Vista St Ste 238
Burbank, CA 91505-4576
Phone
(818) 325-2088
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5611 AZ
Physician Assistant 363A00000X 55208 CA Primary

Addresses

Primary practice location

201 S Buena Vista St Ste 238
Burbank, CA 91505-4576

Mailing address

PO Box 893520
Temecula, CA 92589-3520
Phone (818) 325-2088

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
I20200226002959 CA Practitioner - Physician Assistant 0648590844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Central Ave
Suite 210
Glendale, CA 91202-3644
Phone (818) 325-2088

201 S Buena Vista St
Burbank, CA 91505-4576
Phone (818) 325-2088

39 Congress St
Suite 303
Pasadena, CA 91105-3022
Phone (626) 440-5900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander S Tovar MD a Professional Corporation Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: victoria.gleichman@1781.securemail.prognocis.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1770977340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 893520",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925893520",
            "telephone_number": "818-325-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST STE 238",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054576",
            "telephone_number": "818-325-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEICHMAN",
        "first_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5611",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.