Individual provider Active NPI

Marine Yahyayan, FNP-BC

  • Family Nurse Practitioner
  • Newhall, CA
National Provider Identifier
1780446468
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028622 Issued in CA
Practice address
24636 Jena Dr
Newhall, CA 91321-3749
Phone
(818) 378-1654
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 95028622 CA Primary

Addresses

Primary practice location

24636 Jena Dr
Newhall, CA 91321-3749

Mailing address

24636 Jena Dr
Newhall, CA 91321-3749
Phone (818) 378-1654

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
I20240828001968 CA Practitioner - Nurse Practitioner 1658810122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Hospitalist Medical Group IncGroup PAC ID 8921308636, 30 clinicians

Practice addresses (Care Compare)

1680 E 120TH St
Los Angeles, CA 90059-3026
Phone (424) 338-8144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vep MLK Emergency Medical Group Inc CurrentSince Aug 8, 2024 Accepting new patients
Capital Hospitalist Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

Organizations & group practices 2

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1780446468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24636 JENA DR",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213749",
            "telephone_number": "818-378-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24636 JENA DR",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213749",
            "telephone_number": "818-378-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAHYAYAN",
        "first_name": "MARINE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.