DR. SHAHIN DERBOGHOSSIANS MD
NPI 1710915038
Urology in Glendale, CA

Active since June 28, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 05D0929473 · Waiver
0/100
CMS Quality Rating
116 S LOUISE ST, GLENDALE, CA 91205(818) 507-4340(818) 507-4308 Get Directions Write a Review

NPPES record last updated: January 17, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 17, 2022, Oct 24, 2019 (2 updates tracked since 2019).

About Dr. Shahin Derboghossians Md NPPES

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

DR. SHAHIN DERBOGHOSSIANS MD (NPI 1710915038) is an individual urology provider in Glendale, California, licensed in California (A42661) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through June 12, 2027, and is a graduate of Other (1974).

NPPES Registry Identity

NPI1710915038
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameDR. SHAHIN DERBOGHOSSIANSCredential: MD
Location Address116 S LOUISE STGlendale, CA 91205
Mailing Address116 S Louise StGlendale, CA 91205-1025 · (818) 507-4340 · Fax (818) 507-4308
Fax(818) 507-4308
Sole ProprietorYes
Medical School CMSOtherGraduated 1974
Enumeration DateJune 28, 2006
Last NPPES UpdateJanuary 17, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2022
NPI 1710915038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License Licensed in CA · A42661
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
116 S LOUISE ST, Glendale, CA 91205

Other Identifiers 1

Medicaid00A426610CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Shahin Derboghossians 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 ID6507025418
PECOS Enrollment IDI20120314000072
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0929473

Shahen Boghosian MD · Glendale, CA
Active · expires Jun 12, 2027
CLIA Number05D0929473
Laboratory TypePhysician Office
Certificate Effective DateJune 13, 2025
Certificate Expiration DateJune 12, 2027
Laboratory DirectorShahen Boghosian MD
Laboratory Phone(818) 507-4340
Laboratory LocationShahen Boghosian MD116 S Louise St, Glendale, CA 91205
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 32

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
331 services291 patients
Complete ultrasound scan behind abdominal cavity 76770
A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.
329 services322 patients
Leuprolide acetate (for depot suspension), 7.5 mg J9217
Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.
316 services43 patients
Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies 51729
This procedure helps to measure the pressure inside your bladder while passing fluid. It checks how well your bladder and the tube that carries fluid from your bladder are working. It's important for diagnosing issues with fluid flow and storage.
282 services282 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
278 services225 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
277 services238 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91205 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

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.

Urology
116 S LOUISE ST
GLENDALE, CA 91205
Urology
116 S LOUISE ST
GLENDALE, CA 91205

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 Shahin Derboghossians's NPI number?

The NPI number for Shahin Derboghossians is 1710915038. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Shahin Derboghossians located?

Shahin Derboghossians practices at 116 S Louise St, Glendale, CA 91205. The listed phone number is (818) 507-4340.

What is Shahin Derboghossians's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Shahin Derboghossians enrolled in Medicare?

Yes. Shahin Derboghossians 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.

Does Shahin Derboghossians hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0929473) is associated with this NPI, valid through June 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Shahin Derboghossians was last updated on January 17, 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.