Lucy Vardapetyan
NPI 1164018966ActiveIndividual· Physician Assistant· North Hollywood, CA
Physician Assistant with Shine Mmg Inc, practicing in North Hollywood, California. In 2024 Medicare paid $101,429 for 710 patients, and Part D covered 169 of their prescriptions, 85% of them generic.
Overview
| NPI | 1164018966 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Dec 15, 2020 |
| Last updated in NPPES | Dec 15, 2020 |
| Certified by provider | Dec 15, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 710 |
|---|---|
| Services billed | 1,659 across 8 procedure codes |
| Paid by Medicare | $101,429 |
Part D prescriptions in 2024
| Prescriptions (claims) | 169 · 186 30-day fills |
|---|---|
| Patients | 54 |
| Total drug cost | $12,561 |
| Generic share | 85% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Shine Mmg IncGlendale, CA · 24 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other physician assistants in North Hollywood
- 1407800188
- 1629645635
- 1801127907
- 1407515661
- 1154840551
- 1194261073
- 1265839708
- 1518127729
- 1649927039
- 1811667637
- 1881358356
- 1881949808
All 26 physician assistants in North Hollywood · All physician assistants in California