Individual provider Active NPI

Sunetris Fluellen, M.D.

  • Obstetrics & Gynecology Physician
  • Torrance, CA
National Provider Identifier
1164871513
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A168430 Issued in CA
Practice address
2841 Lomita Blvd Ste 200
Torrance, CA 90505-5110
Phone
(310) 784-6822
Fax
(310) 517-9002
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301110020 MI
Obstetrics & Gynecology Physician 207V00000X A168430 CA Primary

Addresses

Primary practice location

2841 Lomita Blvd Ste 200
Torrance, CA 90505-5110

Mailing address

2841 Lomita Blvd Ste 200
Torrance, CA 90505-5110
Phone (310) 784-6822

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
I20200723001021 CA Practitioner - Obstetrics/Gynecology 0143512624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

2841 Lomita Blvd
Suite 200
Torrance, CA 90505-5110
Phone (310) 517-8952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168430CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc CurrentSince Aug 1, 2020 Accepting new patients
Tmogi Inc Obstetrics & Gynecology CurrentSince Jul 11, 2023 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

2841 Lomita Blvd
Ste 200
Torrance, CA 90505
Phone (310) 517-8952

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

3440 Lomita Blvd
Ste 240
Torrance, CA 90505
Phone (310) 539-5060

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1164871513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055110",
            "telephone_number": "310-784-6822",
            "fax_number": "310-517-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055110",
            "telephone_number": "310-784-6822",
            "fax_number": "310-517-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUELLEN",
        "first_name": "SUNETRIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301110020",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A168430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.