Samara M Kazak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A191387 Issued in CA

Practice address

1040 W Main St
Santa Maria, CA 93458-4273

Phone

(805) 922-8269

Fax

(805) 349-9509

NPI assigned

Mar 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: samara.kazak.p1@direct.cmcentersinc.nextgenshare.com
• Direct secure messaging: samara.kazak.1@17363.direct.athenahealth.com

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.

• Michael Kazak MD Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Santa Maria, CA
  • NPI 1528249232
  Medicare reassignment NPD
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1487230413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934584238",
            "telephone_number": "805-922-8269",
            "fax_number": "805-349-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934584273",
            "telephone_number": "805-922-8269",
            "fax_number": "805-349-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZAK",
        "first_name": "SAMARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A191387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuvleen Kaur, NP
• Monica Kawabe
• Branden Kay
• Samira Kayumi-Rashti, M.D.
• Michael Kazak, MD
• Brittanie Keebler
• Trisha Lynn Keeney
• William Chase Keightley, M.D.
• Keith Dillon, M.D., Inc.
• Keith Tam DDS Professional Corp

• Family Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.