NPIMap

Individual provider Active NPI

Edward Samourjian, M.D.

  • Vascular Surgery Physician
  • Visalia, CA
National Provider Identifier
1184885873
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A113601 Issued in CA
Practice address
820 S Akers St Ste 120
Visalia, CA 93277-8306
Phone
(559) 625-4118
Fax
(559) 625-6004
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A113601 CA
Student in an Organized Health Care Education/Training Program 390200000X LL1864 NV
Vascular Surgery Physician 2086S0129X A113601 CA Primary

Addresses

Primary practice location

820 S Akers St Ste 120
Visalia, CA 93277-8306

Mailing address

2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 948-8143

Other practice location 1

1660 W 3rd St
Los Angeles, CA 90017-1138
Phone (213) 201-0850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730012107 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 8325270457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edward Samourjian Medical Corporation IncGroup PAC ID 0143696971, 2 clinicians

Practice addresses (Care Compare)

1030 S Glendale Ave
Suite 402
Glendale, CA 91205-2866
Phone (818) 230-6522

Hospital & facility affiliations

  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239
  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
  • Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058
  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
76.66 of 100Reported as group
Quality
72.21
Promoting interoperability
0
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal111
Leg revascularization (restoring blood flow)150
Removal of tissue22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113601CAMDGeneral Practice Physician
LL1864NVMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Samourjian Medical Corporation, Inc. Vascular Surgery CurrentSince Sep 1, 2022 Accepting new patients
La Vascular and Endovascular Surgery, a Medical Corporation Vascular Surgery CurrentSince Oct 1, 2018 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Hanford Community Hospital Past Accepting new patients
Gynecologic Oncology Care, a Medical Corporation PastSince Sep 1, 2022 Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Valley Vascular Imaging Inc Past Accepting new patients

Locations

2950 W Burbank Blvd
Burbank, CA 91505
Phone (818) 841-4100

1030 S Glendale Ave
Ste 503
Glendale, CA 91205
Phone (818) 230-6522

1030 S Glendale Ave
Glendale, CA 91205
Phone (818) 240-7673

1030 S Glendale Ave
Ste 402503
Glendale, CA 91205

1030 S Glendale Ave
Ste 402
Glendale, CA 91205
Phone (818) 230-6522

1660 W 3rd St
Los Angeles, CA 90017
Phone (213) 201-0850

18411 Clark St
Ste 305
Tarzana, CA 91356
Phone (818) 326-3406

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: edwardsamourjian@153792.advancedmd-direct.com

Organizations & group practices 10

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 4

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1184885873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-948-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S AKERS ST STE 120",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778306",
            "telephone_number": "559-625-4118",
            "fax_number": "559-625-6004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171138",
            "country_code": "US",
            "telephone_number": "213-201-0850",
            "fax_number": "213-201-0853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMOURJIAN",
        "first_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A113601",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": "LL1864",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A113601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.