Individual provider Active NPI

Tai Marie Samuels, NP

  • Gerontology Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1477853091
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
20206 Issued in CA
Practice address
797 S Fair Oaks Ave
Pasadena, CA 91105-2617
Phone
(626) 795-2244
NPI assigned
Oct 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 20206 CA Primary

Addresses

Primary practice location

797 S Fair Oaks Ave
Pasadena, CA 91105-2617

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

55 S Raymond Ave Ste 200
Alhambra, CA 91801-7103
Phone (626) 570-8005

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
I20130117000327 CA Practitioner - Nurse Practitioner 5294988572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1120 W Washington Blvd
Los Angeles, CA 90015-3316
Phone (213) 623-2225

11600 Indian Hills Rd
Mission Hills, CA 91345-1225
Phone (818) 838-4500

2200 Foothill Blvd
La Canada Flintridge, CA 91011-1413
Phone (818) 790-1103

2601 Via Campo
Montebello, CA 90640-1807
Phone (323) 720-1144

2603 Via Campo
Montebello, CA 90640-1807
Phone (323) 720-1144

401 S Fair Oaks Ave
Pasadena, CA 91105-2603
Phone (626) 304-4400

450 E Huntington Dr
Arcadia, CA 91006-3748
Phone (626) 254-2100

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

988 S Fair Oaks Ave
Pasadena, CA 91105-2626
Phone (626) 799-4194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20206CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 21, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 21, 2013 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

55 S Raymond Ave
Ste 200
Alhambra, CA 91801
Phone (626) 570-8005

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

9810 Las Tunas Dr
Temple City, CA 91780
Phone (626) 309-7600

Interoperability endpoints

  • Direct secure messaging: tsamuels205390@westdirect.optum.com
  • Direct secure messaging: taisamuels@hcpca.allscriptsdirect.net

Organizations & group practices 3

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": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1477853091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052617",
            "telephone_number": "626-795-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 S Raymond Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918017103",
            "country_code": "US",
            "telephone_number": "626-570-8005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "TAI",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "20206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.