Samuel T Grigoryan, NP

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

95165516 Issued in CA

Practice address

29982 Ivy Glenn Dr Ste 203
Laguna Niguel, CA 92677-2097

Phone

(949) 309-7903

Fax

(949) 716-5243

NPI assigned

Jun 22, 2018

Last updated

May 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Psychiatry a Medical CorporationGroup PAC ID 4587057286, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Psychiatry a Medical Corporation

  • Psychiatry Physician
  • Laguna Niguel, CA
  • NPI 1720268980
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1881189892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 E ESCALON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105734",
            "telephone_number": "559-495-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29982 IVY GLENN DR STE 203",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772097",
            "telephone_number": "949-309-7903",
            "fax_number": "949-716-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGORYAN",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95165516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlen David Green, D.O.
• Michael Thomas Griffin, MSW LCSW
• Sandra A. Griffin, R.N. BSN, IBCLC
• Stephen Randall Griffin, OD
• Ted Powers Griffin Jr., OD
• Jeffrey D Gross, M.D.
• Geeta Grover, MD
• Donna Marie Gugliotta, MS
• Isabella Faith Guinto
• Rhodora Gulland

• Psychiatric/Mental Health Registered Nurse in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.