Active NPI
Tu Sang Om, M.D.
- Family Medicine Physician
- Carson, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A96486
- Practice address
- 21501 Avalon Blvd Ste 100
Carson, CA 90745-2210 - Phone
- (310) 835-6627
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A96486 | CA | Primary |
Addresses
Primary practice location
21501 Avalon Blvd Ste 100
Carson, CA 90745-2210
Mailing address
2259 W 230TH St
Torrance, CA 90501-5208
Phone (310) 325-3248
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tom196693@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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Glendale, CA 91202
21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627
Hospital & facility affiliations
- Providence Little Company of Mary Med Ctr Torrance
- Torrance Memorial Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Institute | Family Medicine | Current | Accepting new patients |
| Providence Medical Institute | Family Medicine | Current | Accepting new patients |
Locations
21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627
2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
2382 Crenshaw Blvd
Ste 5
Torrance, CA 90501
Phone (310) 618-6200
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- tom196693@oc.providencedirect.org
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Torrance, CA
- NPI 1417915760
-
- Family Medicine Physician
- Torrance, CA
- NPI 1235182569
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Torrance, CA
- NPI 1902844988
-
- General Acute Care Hospital
- Torrance, CA
- NPI 1467459776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618790400000",
"number": "1487795282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2259 W 230TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905015208",
"telephone_number": "310-325-3248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21501 AVALON BLVD STE 100",
"city": "CARSON",
"state": "CA",
"postal_code": "907452210",
"telephone_number": "310-835-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OM",
"first_name": "TU",
"middle_name": "SANG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A96486",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tom196693@oc.providencedirect.org",
"affiliation": "N",
"address_1": "21501 Avalon Blvd Ste 100",
"city": "Carson",
"state": "CA",
"country_code": "US",
"postal_code": "907452210",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.