Individual provider Active NPI

Samantha Tangchaiburana

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1346649928
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95001107 Issued in CA
Practice address
100 UCLA Medical PLZ Ste 100
Los Angeles, CA 90024-7000
Phone
(310) 481-7545
Fax
(310) 497-9070
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 758670 CA
Acute Care Nurse Practitioner 363LA2100X 95001107 CA Primary

Addresses

Primary practice location

100 UCLA Medical PLZ Ste 100
Los Angeles, CA 90024-7000

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (301) 758-9683

Other practice location 1

1245 16th St Ste 110
Santa Monica, CA 90404-1240
Phone (310) 319-4033

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
I20180430001736 CA Practitioner - Nurse Practitioner 0648534511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCLA Radiology Medical GroupGroup PAC ID 8921902065, 193 clinicians

Practice addresses (Care Compare)

300 UCLA Medical PLZ
Suite B130
Los Angeles, CA 90095-8346
Phone (310) 206-0456

4343 Lankershim Blvd
North Hollywood, CA 91602-2705

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001107CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Radiology Medical Group CurrentSince Apr 3, 2018 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

100 UCLA Medical Plz
Ste 100
Los Angeles, CA 90024
Phone (310) 206-8900

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1245 16th St
Ste 110
Santa Monica, CA 90404
Phone (310) 319-4033

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: stangchaiburana12044@direct.uclahealth.org

Organizations & group practices 2

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 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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1346649928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "301-758-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900247000",
            "telephone_number": "310-481-7545",
            "fax_number": "310-497-9070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 16th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041240",
            "country_code": "US",
            "telephone_number": "310-319-4033",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANGCHAIBURANA",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "758670",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95001107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.