Individual provider Active NPI

Mary Katherine Samplaski, MD

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1093985756
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A131958 Issued in CA
Practice address
1516 San Pablo St FL 5
Los Angeles, CA 90033-5313
Phone
(323) 865-3700
NPI assigned
Mar 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A131958 CA Primary

Addresses

Primary practice location

1516 San Pablo St FL 5
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mary.samplaski@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20140917001368 CA Practitioner - Urology 8426277815 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A131958CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Urology CurrentSince Sep 15, 2014 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 15, 2014 Accepting new patients
Vasweb, PA Urology PastSince May 19, 2024 Accepting new patients
Cedars-Sinai Medical Care Foundation Past Accepting new patients

Locations

125 W Huntington Dr
Bldg B
Arcadia, CA 91007
Phone (626) 281-8288

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

9033 Wilshire Blvd
Ste 360
Beverly Hills, CA 90211
Phone (310) 601-3342

1818 Verdugo Blvd
Ste 318
Glendale, CA 91208

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1516 San Pablo St
Fl 5
Los Angeles, CA 90033
Phone (323) 276-3707

1516 San Pablo St
Ste 5
Los Angeles, CA 90033

1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1204934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1093985756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SAN PABLO ST FL 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-865-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLASKI",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-08",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A131958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.samplaski@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1516 San Pablo St Fl 5",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.