Individual provider Active NPI

Ellie E Samadani, M.D.

  • Ophthalmology Physician
  • San Diego, CA
National Provider Identifier
1033268503
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G83066 Issued in CA
Practice address
3737 Moraga Ave
Suite A105
San Diego, CA 92117-5404
Phone
(858) 273-0200
Fax
(858) 273-0619
NPI assigned
Jan 10, 2007
Last updated
Dec 21, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G83066 CA Primary

Addresses

Primary practice location

3737 Moraga Ave
Suite A105
San Diego, CA 92117-5404

Mailing address

3737 Moraga Ave
Suite A105
San Diego, CA 92117-5404
Phone (858) 273-0200

Other identifiers 1

IdentifierTypeStateIssuer
00G830660MedicaidCA

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
I20071009000406 CA Practitioner - Ophthalmology 4981799749 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3737 Moraga Ave
Suite A105
San Diego, CA 92117-5458
Phone (858) 273-0619

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
81.78
Promoting interoperability
74
Improvement activities
40
Cost
78.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83066CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford G Feldman MD Inc Ophthalmology CurrentSince Oct 13, 2006 Accepting new patients
Thomas S Tooma M D a Professional Corporation Ophthalmology CurrentSince May 1, 2021 Accepting new patients
Thomas S Tooma M D a Professional Corporation Ophthalmology CurrentSince May 1, 2021 Accepting new patients

Locations

3655 Nobel Dr
Ste 130
San Diego, CA 92122
Phone (858) 283-5371

3737 Moraga Ave
Ste A105
San Diego, CA 92117
Phone (858) 273-0200

8010 Frost St
Ste 510
San Diego, CA 92123
Phone (858) 278-9900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1033268503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "SUITE A105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175404",
            "telephone_number": "858-273-0200",
            "fax_number": "858-273-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "SUITE A105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175404",
            "telephone_number": "858-273-0200",
            "fax_number": "858-273-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMADANI",
        "first_name": "ELLIE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G83066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G830660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.