Individual provider Active NPI

Karina Gavrelovna Tavakalyan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Encino, CA
National Provider Identifier
1972091734
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5706 Issued in CA
Practice address
5400 Balboa Blvd Ste 325
Encino, CA 91316-5226
Phone
(818) 782-0559
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X E5706 CA Primary

Addresses

Primary practice location

5400 Balboa Blvd Ste 325
Encino, CA 91316-5226

Mailing address

18701 Sherman Way Ste 2
Reseda, CA 91335-4049
Phone (818) 782-0559

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210616000421 CA Practitioner - Podiatry 9032519806 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premium Podiatry IncGroup PAC ID 6406912401, 5 clinicians

Practice addresses (Care Compare)

445 W Dryden St
Apt 15
Glendale, CA 91202-2341
Phone (616) 482-7890

501 W Glenoaks Blvd 10 PMB
Suite 212
Glendale, CA 91202-2341

6601 Rugby Ave
Suite 100
Huntington Park, CA 90255-4040
Phone (323) 749-9770

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-3277

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue45
Removal of skin lesions1-10
Removal of nail tissue1132
Removal or shaving of skin growth131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5706CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Podiatry, Inc. Foot & Ankle Surgery CurrentSince Mar 1, 2023 Accepting new patients
Vladimir Zeetser, DPM, Inc. Foot & Ankle Surgery CurrentSince Dec 1, 2022 Accepting new patients
Tavakalyan Podiatry PC Foot & Ankle Surgery CurrentSince Sep 20, 2023 Accepting new patients

Locations

5400 Balboa Blvd
Ste 325
Encino, CA 91316
Phone (818) 782-0559

501 W Glenoaks Blvd
Ste 10
Glendale, CA 91202
Phone (616) 482-7890

6601 Rugby Ave
Ste 100
Huntington Park, CA 90255
Phone (323) 749-9770

18701 Sherman Way
Ste 2
Reseda, CA 91335
Phone (818) 782-0559

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1972091734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18701 SHERMAN WAY STE 2",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354049",
            "telephone_number": "818-782-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 325",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165226",
            "telephone_number": "818-782-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKALYAN",
        "first_name": "KARINA",
        "middle_name": "GAVRELOVNA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.