Individual provider Active NPI

Sunmeet Kaur Chawla, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1083352744
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020287 Issued in CA
Practice address
12304 Santa Monica Blvd Ste 116
Los Angeles, CA 90025-2586
Phone
(310) 820-8084
Fax
(909) 495-1301
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95266217 CA
Gerontology Nurse Practitioner 363LG0600X 95020287 CA
Nurse Practitioner 363L00000X 95020287 CA Primary

Addresses

Primary practice location

12304 Santa Monica Blvd Ste 116
Los Angeles, CA 90025-2586

Mailing address

PO Box 10818
San Bernardino, CA 92423-0818
Phone (909) 382-0201

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813001366 CA Practitioner - Nurse Practitioner 6608314398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samir E Hage DO IncGroup PAC ID 7113991373, 3 clinicians

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 202
Redlands, CA 92373-4870
Phone (909) 936-0600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samir E. Hage, D.O., Inc. CurrentSince Jul 22, 2024 Accepting new patients

Locations

101 E Redlands Blvd
Ste 106
Redlands, CA 92373
Phone (818) 484-8611

255 Terracina Blvd
Ste 202
Redlands, CA 92373
Phone (909) 748-6065

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDJJDD/Endpoint/DDJJDD

Organizations & group practices 1

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1083352744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10818",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230818",
            "telephone_number": "909-382-0201",
            "fax_number": "909-495-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD STE 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252586",
            "telephone_number": "310-820-8084",
            "fax_number": "909-495-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAWLA",
        "first_name": "SUNMEET",
        "middle_name": "KAUR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95266217",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95020287",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.