Individual provider Active NPI

Roger Samawi, DO

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1275570822
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8986 Issued in CA
Practice address
1045 Atlantic Ave
Suite 1019
Long Beach, CA 90813-3408
Phone
(562) 901-9228
Fax
(562) 437-5103
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8986 CA Primary

Addresses

Primary practice location

1045 Atlantic Ave
Suite 1019
Long Beach, CA 90813-3408

Mailing address

1045 Atlantic Ave
Suite 1019
Long Beach, CA 90813-3408

Other identifiers 1

IdentifierTypeStateIssuer
00AX89860MedicaidCA

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
I20060927000171 CA Practitioner - Family Practice 6204831142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

1045 Atlantic Ave
Suite 1019
Long Beach, CA 90813-3413
Phone (562) 437-6213

300 Redondo Ave B
Long Beach, CA 90814-2651
Phone (562) 433-7496

Hospital & facility affiliations

  • Grace Home Health Care Home health agency, Long Beach, CA, CCN 557613
  • St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8986CAMDFamily Medicine Physician
8986CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2006 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Aug 1, 2006 Accepting new patients
Careconnectmd Ca PC Family Medicine CurrentSince Jun 24, 2022 Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

1045 Atlantic Ave
Ste 1019
Long Beach, CA 90813
Phone (562) 437-6213

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1275570822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 1019",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 1019",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408",
            "telephone_number": "562-901-9228",
            "fax_number": "562-437-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAWI",
        "first_name": "ROGER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX89860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.