Michelle Roya Banayan, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

16133 Ventura Blvd Ste 340
Encino, CA 91436-2428

Phone

(818) 788-5060

NPI assigned

Dec 9, 2019

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Global Integrated Medical Group, Inc.

  • Primary Care Nurse Practitioner
  • West Covina, CA
  • NPI 1578019485
  Medicare reassignment
• Global Medical GRP Inc

  • Adolescent Medicine (Family Medicine) Physician
  • West Covina, CA
  • NPI 1629682067
  Medicare reassignment
• T Joseph Raoof MD Inc

  • Internal Medicine Physician
  • Encino, CA
  • NPI 1992906093
  Medicare reassignment
• Mobile Physicians Medical Allied Group Inc

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1184199275
  NPD (past)

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1922645993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17661 CORINTHIAN DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163702",
            "telephone_number": "818-903-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16133 VENTURA BLVD STE 340",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362428",
            "telephone_number": "818-788-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14622 Ventura Blvd Ste 118",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914033664",
            "country_code": "US",
            "telephone_number": "818-783-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17661 Corinthian Drive",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "91316",
            "country_code": "US",
            "telephone_number": "818-903-7064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17661 Corinthian Dr",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "913163702",
            "country_code": "US",
            "telephone_number": "818-903-7064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "818 W Carmen Avenue",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "91790",
            "country_code": "US",
            "telephone_number": "626-337-6246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANAYAN",
        "first_name": "MICHELLE",
        "middle_name": "ROYA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maira Balbuena
• Jeffrey B Ballen, D.M.D
• Bambu Skin and Surgery Center LLC
• Shiva Bamshad, OTR/L
• Shabnam Banafsheha
• Samuel Bandarizadeh
• Melody Dina Bandary, O.D.
• Ibukun Oladele Bandele II
• Debra Davis Bandy, MA MFCT
• Chanel Agnes Banez

• Physician Assistant in Encino, CA
• Providers in Encino, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.