AVANTA MEDICAL GROUP
NPI 1770429102
General Practice in Van Nuys, CA
About Avanta Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AVANTA MEDICAL GROUP (NPI 1770429102) is a healthcare organization registered as a general practice in Van Nuys, California and active in the NPI registry since April 2026. The organization lists Vyacheslav Davtian, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Avanta Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Avanta Medical Group, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
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 Avanta Medical Group's NPI number?
The NPI number for Avanta Medical Group is 1770429102. It was assigned to this organization in the NPPES registry on April 27, 2026.
Where is Avanta Medical Group located?
Avanta Medical Group is located at 14649 Victory Blvd Ste 22, Van Nuys, CA 91411. The listed phone number is (818) 796-5558.
What is Avanta Medical Group's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Avanta Medical Group enrolled in Medicare?
Yes. Avanta Medical Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Avanta Medical Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Avanta Medical Group, in Internal Medicine and Podiatry. 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 Avanta Medical Group was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Avanta Medical Group · NPI 1770429102
General Practice organization in Van Nuys, California. Organization record, active in the CMS NPPES registry since April 27, 2026.
## Identity
- **NPI:** 1770429102 (Entity type: Organization)
- **Enumerated:** April 27, 2026
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Vyacheslav Davtian, CEO
## Practice location
- **Address:** 14649 VICTORY BLVD STE 22, Van Nuys, CA 91411-4101
- **Phone:** (818) 796-5558
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Podiatry (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1770429102) · Data from the CMS NPPES public registry.