GINA ALEXANDRA KHACHATRIAN MSPA
NPI 1780495325
Physician Assistant in Glendale, CA

Active since January 14, 2025PECOS Enrolled
1505 WILSON TER STE 200, GLENDALE, CA 91206(323) 646-0716 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gina Alexandra Khachatrian Mspa NPPES

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

GINA ALEXANDRA KHACHATRIAN MSPA (NPI 1780495325) is an individual physician assistant in Glendale, California, licensed in California (65972) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1780495325
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameGINA ALEXANDRA KHACHATRIANCredential: MSPA
Location Address1505 WILSON TER STE 200Glendale, CA 91206-4073
Mailing Address3735 Fairesta StGlendale, CA 91214-1720 · (323) 646-0716
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 14, 2025
Last NPPES UpdateMarch 31, 2025
NPPES CertifiedMarch 31, 2025
NPI 1780495325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in CA · 65972
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1505 WILSON TER STE 200, Glendale, CA 91206

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Gina Alexandra Khachatrian Mspa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204336381
PECOS Enrollment IDI20250822003286
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91206 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 6

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

Internal Medicine (Hematology & Oncology)
1505 WILSON TER STE 200
GLENDALE, CA 91206
Pharmacy (Clinic Pharmacy)
1505 WILSON TER STE 200
GLENDALE, CA 91206
Nurse Practitioner (Adult Health)
1505 WILSON TER STE 200
GLENDALE, CA 91206
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1505 WILSON TER STE 200
GLENDALE, CA 91206
Internal Medicine (Hematology & Oncology)
1505 WILSON TER STE 200
GLENDALE, CA 91206
Non-Pharmacy Dispensing Site
1505 WILSON TER STE 200
GLENDALE, CA 91206

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780495325, enumerated as an "individual" on January 14, 2025.

The provider is located at 1505 WILSON TER STE 200 GLENDALE, CA 91206 and the phone number is (323) 646-0716.

Physician Assistant with taxonomy code 363A00000X.