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ANDRE PANOSSIAN M.D.
NPI 1710177845
Plastic Surgery in Pasadena, CA

Active since July 25, 2007Opted out of Medicare · through Nov 20, 2026
39 CONGRESS ST STE 402, PASADENA, CA 91105(800) 958-3778(800) 958-3778 Get Directions Write a Review

NPPES record last updated: September 15, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 15, 2019, Mar 2, 2019 (2 updates tracked since 2019).

About Andre Panossian M.d. NPPES

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

ANDRE PANOSSIAN M.D. (NPI 1710177845) is an individual plastic surgery provider in Pasadena, California, licensed in California (A76052) and active in the NPI registry since July 2007. He has opted out of Medicare through November 20, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1710177845
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameANDRE PANOSSIANCredential: M.D.
Location Address39 CONGRESS ST STE 402Pasadena, CA 91105-3024
Mailing Address39 Congress St Ste 402Pasadena, CA 91105-3024 · (800) 958-3778 · Fax (800) 958-3778
Phone(800) 958-3778
Fax(800) 958-3778
Sole ProprietorYes
Enumeration DateJuly 25, 2007
Last NPPES UpdateSeptember 15, 20192 updates tracked since enumeration
✔ NPI 1710177845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in CA · A76052
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
39 CONGRESS ST STE 402, Pasadena, CA 91105
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Other Names 1

Other Name (5)Andre A Panossian M.d.

Other Identifiers 2

Medicaid1710177845CA
Other00A760520CA · Blue Shield #

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Andre Panossian M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 20, 2018 through November 20, 2026.

Opt-Out Effective DateNovember 20, 2018
Opt-Out In Effect ThroughNovember 20, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91105 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
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 2

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

NATALIE WONG PA-C
Physician Assistant
39 CONGRESS ST STE 402
PASADENA, CA 91105
Los Angeles County (626) 765-6885
ANDRE PANOSSIAN MD A PROFESSIONAL CORPORATION
Plastic Surgery
39 CONGRESS ST STE 402
PASADENA, CA 91105
Los Angeles County (800) 958-3778

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 Andre Panossian's NPI number?

The NPI number for Andre Panossian is 1710177845. It was assigned to this individual provider in the NPPES registry on July 25, 2007. The provider is also known as Andre A Panossian M.D..

Where is Andre Panossian located?

Andre Panossian practices at 39 Congress St Ste 402, Pasadena, CA 91105. The listed phone number is (800) 958-3778.

What is Andre Panossian's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Andre Panossian enrolled in Medicare?

No. Andre Panossian has opted out of Medicare through November 20, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Andre Panossian was last updated on September 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.