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TATEVIK GRIGORYAN
NPI 1477302305
Nurse Practitioner - Psychiatric/Mental Health in Fremont, CA

Active since May 14, 2024PECOS EnrolledAccepts Medicare Assignment
39159 PASEO PADRE PKWY STE 121, FREMONT, CA 94538(510) 952-1190(510) 972-5976 Get Directions Write a Review

NPPES record last updated: May 14, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Tatevik Grigoryan NPPES

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

TATEVIK GRIGORYAN (NPI 1477302305) is an individual psychiatric/mental health provider in Fremont, California, licensed in California (95028093) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1477302305
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameTATEVIK GRIGORYAN
Location Address39159 PASEO PADRE PKWY STE 121Fremont, CA 94538-1600
Mailing Address18325 Sherman Way, Suite BReseda, CA 91335 · (818) 414-1981
Phone(510) 952-1190
Fax(510) 972-5976
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 14, 2024
NPPES CertifiedMay 6, 2024
✔ NPI 1477302305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95028093
Also ListedRegistered NurseTaxonomy 163W00000X · License 95222787 (CA)
39159 PASEO PADRE PKWY STE 121, Fremont, CA 94538
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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

Tatevik Grigoryan 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 ID3173046620
PECOS Enrollment IDI20250331003111
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 Tatevik Grigoryan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Revive Mental Health Nursing Inc
301 mi
Psychiatric/Mental Health
16933 PARTHENIA ST STE 212
Northridge, CA 91343
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Revive Mental Health Center Inc
NPI 1619787504 (818) 217-1212

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94538 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MARIA PRECIADO-RODRIGUEZ PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190
NUTSA KHAKHIASHVILI AMFT
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (544) 928-7954
ESTHER KANG
Counselor (Mental Health)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190
STEPHANIE CARTER
Social Worker (Clinical)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (858) 228-7667
MRS. TIFFANY MONIQUE MARTIN
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190
GENISIS SARAHI FRANCO ALVAREZ LPCC
Counselor (Professional)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190
MONIQUE TONYA ORDONE
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190
GABRIELA CARINA DELGADO LMFT
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Alameda County (510) 952-1190

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 Tatevik Grigoryan's NPI number?

The NPI number for Tatevik Grigoryan is 1477302305. It was assigned to this individual provider in the NPPES registry on May 14, 2024.

Where is Tatevik Grigoryan located?

Tatevik Grigoryan practices at 39159 Paseo Padre Pkwy Ste 121, Fremont, CA 94538. The listed phone number is (510) 952-1190.

What is Tatevik Grigoryan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tatevik Grigoryan enrolled in Medicare?

Yes. Tatevik Grigoryan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Tatevik Grigoryan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tatevik Grigoryan reassigns Medicare benefits to Revive Mental Health Nursing Inc (Northridge, CA). The 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 Tatevik Grigoryan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tatevik Grigoryan was last updated on May 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.