Individual provider Active NPI

Erene Nawar Sami, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Mission Viejo, CA
National Provider Identifier
1023335817
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A120158 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 485
Mission Viejo, CA 92691-8025
Phone
(949) 364-5830
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A120158 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A120158 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 485
Mission Viejo, CA 92691-8025

Mailing address

100 E Valencia Mesa Dr Ste 105
Fullerton, CA 92835-3816
Phone (714) 446-5640

Other practice location 1

100 E Valencia Mesa Dr Ste 105
Fullerton, CA 92835-3816
Phone (714) 446-5640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address enawar1372992@oc.providencedirect.org

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
I20150924002362 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 6608189675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Northwestern University Feinberg Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

26800 Crown Valley Pkwy
Suite 485
Mission Viejo, CA 92691-8025
Phone (949) 364-5830

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120158CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heal Endocrine & Diabetes, PC Endocrinology, Diabetes & Metabolism CurrentSince Dec 16, 2022 Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

26800 Crown Valley Pkwy
Ste 485
Mission Viejo, CA 92691
Phone (949) 364-5830

Organizations & group practices 2

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1023335817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353816",
            "telephone_number": "714-446-5640",
            "fax_number": "714-446-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 485",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918025",
            "telephone_number": "949-364-5830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Valencia Mesa Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353816",
            "country_code": "US",
            "telephone_number": "714-446-5640",
            "fax_number": "714-446-5625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMI",
        "first_name": "ERENE",
        "middle_name": "NAWAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A120158",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A120158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enawar1372992@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "100 E Valencia Mesa Dr Ste 105",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.