Individual provider Active NPI

Rama Samoori, D.O.

  • Family Medicine Physician
  • Mission Viejo, CA
National Provider Identifier
1457445884
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8999 Issued in CA
Practice address
26732 Crown Valley Pkwy
#170
Mission Viejo, CA 92691-6306
Phone
(949) 347-6044
Fax
(949) 347-6069
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8999 CA Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy
#170
Mission Viejo, CA 92691-6306

Mailing address

26522 La Alameda
Suite 120
Mission Viejo, CA 92691-6330
Phone (949) 282-1671

Other identifiers 1

IdentifierTypeStateIssuer
20A8999OtherCALICENCE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsamoori1182020@oc.providencedirect.org

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
I20050613000619 CA Practitioner - Family Practice 4880638733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26732 Crown Valley Pkwy
Mission Viejo, CA 92691-6337

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8999CAMDFamily Medicine Physician
8999CAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

100 E Valencia Mesa Dr
#1051182
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26732 Crown Valley Pkwy
Ste 170
Mission Viejo, CA 92691
Phone (949) 364-7246

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rsamoori1182020@oc.providencedirect.org

Organizations & group practices 5

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 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1457445884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "#170",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-347-6044",
            "fax_number": "949-347-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOORI",
        "first_name": "RAMA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "20A8999",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsamoori1182020@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26732 Crown Valley Pkwy",
            "address_2": "#170",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.