Organization Active NPI

Mikayel Grigoryan MD Inc

  • Neurological Surgery Physician
  • Glendale, CA
National Provider Identifier
1891348793
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MIKAYEL GRIGORYAN MD INC
Practice address
1451 E Chevy Chase Dr Ste 201
Glendale, CA 91206-4056
Phone
(818) 265-2245
NPI assigned
Jul 19, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Mikayel Grigoryan, MDNPI 1801003686
Title
President
Phone
(650) 995-3193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary
Neurology Physician 2084N0400X NU
Vascular Neurology Physician 2084V0102X NU
Neuroradiology Physician 2085N0700X NU
Vascular & Interventional Radiology Physician 2085R0204X NU

Addresses

Primary practice location

1451 E Chevy Chase Dr Ste 201
Glendale, CA 91206-4056

Mailing address

3310 Sparr Blvd
Glendale, CA 91208-1663
Phone (650) 995-3193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190925000860 CA Part B Supplier - Clinic/Group Practice 8325378946 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1891348793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 SPARR BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081663",
            "telephone_number": "650-995-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E CHEVY CHASE DR STE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064056",
            "telephone_number": "818-265-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKAYEL GRIGORYAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "MIKAYEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-995-3193",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.