Samina Ahmed, MD
Individual provider Active NPI Hematology & Oncology Physician · Santa Clara, CA
NPI 1114180197 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1114180197
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- A103776 (CA)
- Practice address
- 710 Lawrence Expy
Dept. 440
Santa Clara, CA 95051-5173 - Phone
- (408) 851-4328
- NPI assigned
- Jul 9, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Hematology/Oncology
- Education
- Rush Medical College of Rush University, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
3430 E la Palma Ave
Anaheim, CA 92806-2020
Phone (888) 988-2800
3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-2010
5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088
Hospital & facility affiliations
- Kaiser Foundation Hospital - Orange County - Anaheim
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110915000333 | CA | Practitioner - Hematology/Oncology |
1658542071 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103776 | CA | MD | General Practice Dentistry |
| A103776 | CA | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
3430 E La Palma Ave
Fl 6
Anaheim, CA 92806
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | A103776 | CA | Yes |
Addresses
Primary practice location
710 Lawrence Expy
Dept. 440
Santa Clara, CA 95051-5173
Mailing address
3430 E la Palma Ave
6TH Floor
Anaheim, CA 92806-2020
Phone (888) 988-2800
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 |
Other providers in Santa Clara, CA
- Gurpreet K. Ahluwalia
- Ahmad Mokbil and Dhaval Patel Dental Corporation
- Najla Ahmadzia
- Aiysha Ahmed
- Farhana Ahmed
- Jeong Yun Ahn
- Michael S. Ahn
- Sang Kyun Ahn
- Ritu Ahuja
- Sharvika Ahuja
All providers in Santa Clara, CA · Hematology & Oncology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.