BRAD NANIGIAN MD
NPI 1205807484
Student in an Organized Health Care Education/Training Program in Stockton, CA

Q: What is Brad Nanigian's NPI number?

The NPI number for Brad Nanigian is 1205807484. It was assigned to this individual provider in the NPPES registry on January 27, 2006.

Q: What is Brad Nanigian's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Brad Nanigian was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 27, 2006PECOS EnrolledAccepts Medicare Assignment

7373 WEST LN, SURGERY CLINIC, STOCKTON, CA 95210(209) 476-2120 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Brad Nanigian Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRAD NANIGIAN MD (NPI 1205807484) is an individual student in an organized health care education/training program in Stockton, California and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2000).

NPPES Registry Identity

NPI1205807484

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameBRAD NANIGIANCredential: MD

Location Address7373 WEST LN, SURGERY CLINICStockton, CA 95210-3377

Mailing Address5232 U StSacramento, CA 95817-1646 · (916) 456-5676

Phone(209) 476-2120

Sole ProprietorYes

Medical School CMSTemple University School Of MedicineGraduated 2000

Enumeration DateJanuary 27, 2006

Last NPPES UpdateFebruary 11, 2022

✔ NPI 1205807484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

7373 WEST LN, Stockton, CA 95210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brad Nanigian Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759382534

PECOS Enrollment IDI20070122000365

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Brad Nanigian reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

Same address

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASDEEP KAUR GILL PHARMD

Pharmacist (Ambulatory Care)