Individual provider Active NPI

Samuel James Larussa, M.D.

  • Vascular & Interventional Radiology Physician
  • North Hollywood, CA
National Provider Identifier
1376993063
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
296444 Issued in NY
Practice address
4343 Lankershim Blvd Ste 300
North Hollywood, CA 91602-2705
Phone
(310) 301-6800
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A186634 CA
Vascular & Interventional Radiology Physician 2085R0204X A186634 CA
Vascular & Interventional Radiology Physician 2085R0204X 296444 NY Primary

Addresses

Primary practice location

4343 Lankershim Blvd Ste 300
North Hollywood, CA 91602-2705

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

125 Paterson St
Clinical Academic Building CAB 7300
New Brunswick, NJ 08901-1962
Phone (732) 235-6096

Other practice location 2

1400 Pelham Pkwy S
Bronx, NY 10461-1197
Phone (718) 918-5000

Other practice location 3

757 Westwood Plz
Los Angeles, CA 90095-1197
Phone (310) 301-6800

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address sjl2003@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250108001997 NY Practitioner - Diagnostic Radiology 5395102974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Physician Services PCGroup PAC ID 0547579427, 643 clinicians
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

525 E 68TH St Box
585 Cornell University Med College
New York, NY 10021-4870
Phone (212) 746-2059

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A186634CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Diagnostic Radiology CurrentSince Dec 28, 2024 Accepting new patients
Weill Cornell Imaging at New York Presbyterian Diagnostic Radiology Current Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 28, 2024 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 25, 2024 Accepting new patients
Kings Physician Services, PC Diagnostic Radiology Current Accepting new patients
Weill Cornell Medical Imaging Diagnostic Radiology CurrentSince Dec 28, 2024 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

515 6th St
Brooklyn, NY 11215
Phone (718) 780-3031

520 E 70th St
New York, NY 10021
Phone (212) 746-0838

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 7

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 5

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1376993063",
    "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": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 LANKERSHIM BLVD STE 300",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022705",
            "telephone_number": "310-301-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Paterson St",
            "address_2": "Clinical Academic Building CAB 7300",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011962",
            "country_code": "US",
            "telephone_number": "732-235-6096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611197",
            "country_code": "US",
            "telephone_number": "718-918-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "757 Westwood Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900951197",
            "country_code": "US",
            "telephone_number": "310-301-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARUSSA",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A186634",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A186634",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "296444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjl2003@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.