Individual provider Active NPI

Samantha Claire Lewis Cohen, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1174825731
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
A110987 Issued in CA
Practice address
4036 3Rd Ave
San Diego, CA 92103-2102
Phone
(619) 320-8696
Fax
(626) 314-5242
NPI assigned
Dec 2, 2010
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A110987 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X A110987 CA Primary

Addresses

Primary practice location

4036 3Rd Ave
San Diego, CA 92103-2102

Mailing address

1612 32ND St
San Diego, CA 92102-1608
Phone (626) 825-0927

Other practice location 1

700 2nd St Ste H
Encinitas, CA 92024-4459
Phone (619) 320-8696

Other names 1

  • Miss Samantha Claire Lewis Former name

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
I20110722000673 CA Practitioner - Pediatric Medicine 8820266588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A110987CAMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 17, 2017 Accepting new patients
Samantha Cohen, MD, Inc. Developmental - Behavioral Pediatrics CurrentSince Dec 10, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 17, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Luis Alesandro Larrazabal Martinez MD PC Pediatrics PastSince Mar 30, 2025 Accepting new patients

Locations

700 2nd St
Ste H
Encinitas, CA 92024
Phone (619) 320-8696

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

3405 Kenyon St
Ste 210
San Diego, CA 92110

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1174825731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 32ND ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021608",
            "telephone_number": "626-825-0927",
            "fax_number": "626-314-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032102",
            "telephone_number": "619-320-8696",
            "fax_number": "626-314-5242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 2nd St Ste H",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920244459",
            "country_code": "US",
            "telephone_number": "619-320-8696",
            "fax_number": "626-314-5242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "SAMANTHA",
        "middle_name": "CLAIRE LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A110987",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "A110987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LEWIS",
            "middle_name": "CLAIRE",
            "prefix": "MISS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.