Individual provider Active NPI

Adel Fahmy Samaan, MD

  • Obstetrics & Gynecology Physician
  • Santa Monica, CA
National Provider Identifier
1386664233
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A38660 Issued in CA
Practice address
2118 Wilshire Blvd
Ste 1002
Santa Monica, CA 90403-5704
Phone
(310) 914-0130
Fax
(818) 907-6157
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A38660 CA
Obstetrics & Gynecology Physician 207V00000X A38660 CA Primary

Addresses

Primary practice location

2118 Wilshire Blvd
Ste 1002
Santa Monica, CA 90403-5704

Mailing address

2118 Wilshire Blvd
Ste 1002
Santa Monica, CA 90403-5704
Phone (310) 914-0130

Other practice location 1

1990 Westwood Blvd
Suite 240
Los Angeles, CA 90025-4650
Phone (310) 441-8880

Other identifiers 2

IdentifierTypeStateIssuer
00A38660OtherCAMEDI-CAL
2275017MedicaidCA

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
I20040225000537 CA Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 4183510233 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1613 S Vermont Ave
Los Angeles, CA 90006-4521
Phone (310) 292-4202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38660CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Wellness Center Inc PastSince Sep 1, 2016 Accepting new patients

Organizations & group practices 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1386664233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 WILSHIRE BLVD",
            "address_2": "STE 1002",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035704",
            "telephone_number": "310-914-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 WILSHIRE BLVD",
            "address_2": "STE 1002",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035704",
            "telephone_number": "310-914-0130",
            "fax_number": "818-907-6157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Westwood Blvd",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900254650",
            "country_code": "US",
            "telephone_number": "310-441-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMAAN",
        "first_name": "ADEL",
        "middle_name": "FAHMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A38660",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A38660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A38660",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2275017",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.