NPIMap

Individual provider Active NPI

Gerard H Boghossian, D.P.M.

  • Podiatrist
  • Lancaster, CA
National Provider Identifier
1942263322
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4323 Issued in CA
Practice address
42135 10TH St W
Suite 101
Lancaster, CA 93534-7095
Phone
(661) 726-5005
Fax
(661) 726-5377
NPI assigned
Apr 7, 2006
Last updated
Mar 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4323 CA Primary

Addresses

Primary practice location

42135 10TH St W
Suite 101
Lancaster, CA 93534-7095

Mailing address

42135 10TH St W
Suite 101
Lancaster, CA 93534-7095
Phone (661) 726-5005

Other identifiers 1

IdentifierTypeStateIssuer
00E43231OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050812001011 CA Practitioner - Podiatry 4486684156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Podmed Clinic Inc a Podiatric CorporationGroup PAC ID 7517018971, 3 clinicians

Practice addresses (Care Compare)

41210 11TH St W
Suite K
Palmdale, CA 93551-1447
Phone (661) 480-0738

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue467
Removal of skin lesions1-10
Removal of nail tissue39
Removal or shaving of skin growth13
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4323CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Medical Group Holding Company, Inc. CurrentSince Feb 12, 2018 Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Radadvantage a Professional Corporation Past Accepting new patients
Kenneth V. Miselis, M.D. Inc. Past Accepting new patients

Locations

43839 15th St W
Lancaster, CA 93534
Phone (661) 945-5984

43839 15th St W
Ste 130
Lancaster, CA 93534

44469 10th St W
Lancaster, CA 93534
Phone (661) 945-9411

39115 Trade Center Dr
Palmdale, CA 93551
Phone (661) 223-3880

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gerard.boghossian.1@14402.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1942263322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42135 10TH ST W",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347095",
            "telephone_number": "661-726-5005",
            "fax_number": "661-726-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42135 10TH ST W",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347095",
            "telephone_number": "661-726-5005",
            "fax_number": "661-726-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGHOSSIAN",
        "first_name": "GERARD",
        "middle_name": "H",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00E43231",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.