Individual provider Active NPI

Samuel Loredo, MD

  • Obstetrics & Gynecology Physician
  • Merced, CA
National Provider Identifier
1164532958
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G55263 Issued in CA
Practice address
139 West El Portal Drive
Suite a
Merced, CA 95348
Phone
(209) 722-2716
Fax
(209) 722-2767
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G55263 CA Primary

Addresses

Primary practice location

139 West El Portal Drive
Suite a
Merced, CA 95348

Mailing address

139 W El Portal Dr
Suite a
Merced, CA 95348-2844
Phone (209) 722-2716

Other identifiers 1

IdentifierTypeStateIssuer
00G552631MedicaidAR

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
I20071208000208 CA Practitioner - Obstetrics/Gynecology 5193814408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 W El Portal Dr
Suite a
Merced, CA 95348-2844
Phone (209) 722-2716

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Merced, CA, CCN 050444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G55263CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vepema Laborist Medical Group, Inc. Obstetrics & Gynecology CurrentSince Feb 1, 2023 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Jan 1, 2026 Accepting new patients
Dignity Health Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164532958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 W EL PORTAL DR",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482844",
            "telephone_number": "209-722-2716",
            "fax_number": "209-722-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WEST EL PORTAL DRIVE",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-722-2716",
            "fax_number": "209-722-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOREDO",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G55263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G552631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.