Alique Boulgourjian, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35606 Issued in CA

Practice address

4353 Park Terrace Dr Ste 150
Westlake Village, CA 91361-4639

Phone

(805) 987-5300

Fax

(818) 707-7668

NPI assigned

Nov 14, 2023

Sex

Female

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Western University of Health Sciences College of Dental Med, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul J Dougherty M D IncGroup PAC ID 9739171828, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aboulgourjian@uvpdlv.intellechartdirect.net

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.

• Paul J Dougherty M D Inc

  • Ophthalmology Physician
  • Westlake Village, CA
  • NPI 1649203639

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Gary L Etting OD an Optometric Corp

  • Optometrist
  • Encino, CA
  • NPI 1306950829
  NPD (past)
• Joseph & Nace Optometric Corporation

  • Vision Therapy Optometrist
  • Encino, CA
  • NPI 1144994104

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1891569356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 PARK TERRACE DR STE 150",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614639",
            "telephone_number": "805-987-5300",
            "fax_number": "818-707-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 PARK TERRACE DR STE 150",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614639",
            "telephone_number": "805-987-5300",
            "fax_number": "818-707-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULGOURJIAN",
        "first_name": "ALIQUE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Boranian
• Steven Borg, C.C.P.
• Rachel Bornfeld, LMFT, ATR
• Tiffany Bornn, PHD
• Sarah Holroyde Borrego, LCSW25329
• Patricia Y. Bourdon, M.A., M.F.T.
• Vincent Dayton Bovino, DPT
• Madison Nicole Braafhart, AMFT
• Kathleen Elizabeth Bradley, M.D.
• Jennifer Lee Brady, LCSW

• Optometrist in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.