Individual provider Active NPI

Daniel Samano, M.D.

  • Family Medicine Physician
  • Calexico, CA
National Provider Identifier
1003263963
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A150973 Issued in CA
Practice address
420 Heffernan Ave Ste 2B
Calexico, CA 92231-4718
Phone
(760) 618-4625
NPI assigned
May 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A150973 CA Primary

Addresses

Primary practice location

420 Heffernan Ave Ste 2B
Calexico, CA 92231-4718

Mailing address

420 Heffernan Ave Ste 2B
Calexico, CA 92231-4718
Phone (760) 618-4625

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180105001399 CA Practitioner - Family Practice 6608133111 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9550 Escondido Ave
Hesperia, CA 92345-9120
Phone (833) 574-2273

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A150973CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jul 16, 2019 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 25, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Oct 15, 2022 Accepting new patients
Imperial Valley Family Care Medical Group Apc CurrentSince Oct 15, 2022 Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2024 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Mar 25, 2022 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 16, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

125 S 5th St
Ste A
Brawley, CA 92227
Phone (760) 344-8100

420 Heffernan Ave
Ste B
Calexico, CA 92231

251 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2500

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 204B
Loma Linda, CA 92354
Phone (909) 558-6526

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Interoperability endpoints

  • Direct secure messaging: dsamano72445@direct.llu.edu

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1003263963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 HEFFERNAN AVE STE 2B",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922314718",
            "telephone_number": "760-618-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 HEFFERNAN AVE STE 2B",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922314718",
            "telephone_number": "760-618-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANO",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-20",
        "last_updated": "2024-05-07",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A150973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Calexico, CA

Sources for this page

Verify at the official NPI Registry.