Individual provider Active NPI

Kaloni Sam, FNP-BC

  • Family Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1306681929
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025391 Issued in CA
Practice address
2010 E 1St St Ste 100
Santa Ana, CA 92705-4086
Phone
(714) 556-7246
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025391 CA Primary

Addresses

Primary practice location

2010 E 1St St Ste 100
Santa Ana, CA 92705-4086

Mailing address

2010 E 1St St Ste 100
Santa Ana, CA 92705-4086
Phone (714) 556-7246

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925004857 CA Practitioner - Nurse Practitioner 0042715450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
California Wound Healing Medical Group Inc.Group PAC ID 7315033198, 21 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Alhambra, CA 91801-1022
Phone (323) 264-7796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Edge Medical Group - Ca CurrentSince Dec 9, 2025 Accepting new patients
California Wound Healing Medical Group Inc. CurrentSince Aug 15, 2025 Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

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.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1306681929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "KALONI",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.