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BROADWAY FAMILY OPTOMETRY
NPI 1265101158
Optometrist in Glendale, CA

Active since September 13, 2021
113 E BROADWAY, GLENDALE, CA 91205(818) 241-7719(818) 241-7719 Get Directions Write a Review

NPPES record last updated: September 13, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Broadway Family Optometry NPPES

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

BROADWAY FAMILY OPTOMETRY (NPI 1265101158) is a healthcare organization registered as an optometrist in Glendale, California and active in the NPI registry since September 2021. The organization lists Boris Mardian, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1265101158
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameBROADWAY FAMILY OPTOMETRY
Location Address113 E BROADWAYGlendale, CA 91205-1006
Mailing Address113 E BroadwayGlendale, CA 91205-1006 · (818) 241-7719
Phone(818) 241-7719
Fax(818) 241-7719
Organization SubpartNo
Authorized OfficialBoris MardianOptometrist · (818) 241-7719
Enumeration DateSeptember 13, 2021
NPPES CertifiedSeptember 13, 2021
✔ NPI 1265101158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
113 E BROADWAY, Glendale, CA 91205
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broadway Family Optometry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Broadway Family Optometry, which bills Medicare for the services this clinician delivers.

Clinician (1)

Boris Mardian, OD.
Optometry
NPI 1477579506
113 E BROADWAY
Glendale, CA 91205
(818) 241-7719
✔ PECOS✔ Accepts MedicareSame address

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadway Family Optometry's NPI number?

The NPI number for Broadway Family Optometry is 1265101158. It was assigned to this organization in the NPPES registry on September 13, 2021.

Where is Broadway Family Optometry located?

Broadway Family Optometry is located at 113 E Broadway, Glendale, CA 91205. The listed phone number is (818) 241-7719.

What is Broadway Family Optometry's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Broadway Family Optometry enrolled in Medicare?

Yes. Broadway Family Optometry is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Broadway Family Optometry?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Broadway Family Optometry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Broadway Family Optometry was last updated on September 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.