Chanmee Praise Seo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A193273 Issued in CA

Practice address

4050 Beyer Blvd
San Ysidro, CA 92173-2007

Phone

(619) 662-4100

NPI assigned

Jun 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Mississippi School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Specialists Medical CorporationGroup PAC ID 6709834112, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cpraiseseo55273@syhealth.direct-ci.com
• Direct secure messaging: chanmee.praise.seo.1@24668.direct.athenahealth.com

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.

• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1649223777
  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • Campo, CA
  • NPI 1174164719
  NPD
• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1942255195
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  Care Compare affiliation

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1336717206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12313 CREEKWOOD AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-662-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "CHANMEE",
        "middle_name": "PRAISE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PTL6835",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A193273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "PTL6835",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sudeepa Sankuratri
• Sam Sardo, SLP
• Martina Nittra Savedra, LMFT
• SBCS Corporation
• Jonathan Semaan, DO
• Mara Serrano
• Ariel Natalie Servin, HE
• Tina Shahidyazdani, MD
• Laurie Michelle Shear, MFT
• Hasmukh L. Sheth, MD

• Family Medicine Physician in San Ysidro, CA
• Providers in San Ysidro, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.