NPIMap

Individual provider Active NPI

Sameh F Gadallah, M.D.

  • Specialist
  • Lancaster, CA
National Provider Identifier
1205897535
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A49405 Issued in CA
Practice address
43723 20TH St W
Lancaster, CA 93534-4784
Phone
(661) 674-4222
Fax
(661) 647-4220
NPI assigned
Mar 28, 2006
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A49405 CA Primary

Addresses

Primary practice location

43723 20TH St W
Lancaster, CA 93534-4784

Mailing address

PO Box 2030
Lancaster, CA 93539-2030
Phone (661) 674-4222

Other identifiers 1

IdentifierTypeStateIssuer
00A494050MedicaidCA

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
I20070524000249 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7911907910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Antelope Valley Cardiology AssociatesGroup PAC ID 7416054614, 5 clinicians

Practice addresses (Care Compare)

43723 20TH St W
Suite 101
Lancaster, CA 93534-4784
Phone (661) 674-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.02

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A49405CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Hospital Corporation Past Accepting new patients
Municipality of Skagway Past Accepting new patients
Los Angeles Cardiology Associates Specialist Past Accepting new patients
Sanjaya Khanal, M.D., Inc. Past Accepting new patients
Antelope Valley Health Care District Past Accepting new patients
Fairview Hospital Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: samgadallah@avca.allscriptsdirect.net

Organizations & group practices 9

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.

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1205897535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2030",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392030",
            "telephone_number": "661-674-4222",
            "fax_number": "661-674-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43723 20TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344784",
            "telephone_number": "661-674-4222",
            "fax_number": "661-647-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADALLAH",
        "first_name": "SAMEH",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A49405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A494050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.