Sam Seunghae Ahn, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

F1333 Issued in TX

Practice address

1082 Glendon Ave
Los Angeles, CA 90024-2908

Phone

(310) 209-2011

Fax

(310) 209-2113

NPI assigned

Jun 28, 2006

Last updated

Aug 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Vascular Surgery

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Vascular Associates IncGroup PAC ID 7911901731, 5 clinicians

DFW Vascular Group LLPGroup PAC ID 0941391072, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: sam.ahn@1290.direct.myezyaccess.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Vascular Associates Inc.

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1225062490
  Medicare reassignment Care Compare group NPD Authorized official
• DFW Vascular Group LLP

  • Vascular Surgery Physician
  • Desoto, TX
  • NPI 1467585786
  Medicare reassignment Care Compare group
• Mission Surgical Clinic, Inc.

  • Surgery Physician
  • Riverside, CA
  • NPI 1457300436
  Medicare reassignment NPD
• Sonotape, Inc.

  • Diagnostic Ultrasound Physician
  • Glendale, CA
  • NPI 1346387420
  NPD
• Miller-Franklin Limited Liability Partnership

  dba Sovereign Anesthesia of Texas

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
  • NPI 1821253907
  NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)
• Dignity Health

  dba St. John's Regional Medical Center

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  NPD (past)
• Mission Surgical Center Inc

  • Ambulatory Surgical Clinic/Center
  • Riverside, CA
  • NPI 1447194030
  NPD (past)
• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• Regents Univ of Calif Los Angeles

  dba Resnick Neuropsychiatric Hospital at UCLA

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1952308363
  NPD (past)
• Riverside Healthcare System, L.P.

  dba Riverside Community Hospital

  • Rehabilitation Hospital Unit
  • Riverside, CA
  • NPI 1053358010
  NPD (past)
• Methodist Hospital of Dallas

  dba Methodiat Dallas Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1255391959
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1497783831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1082 GLENDON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242908",
            "telephone_number": "310-209-2011",
            "fax_number": "310-209-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1082 GLENDON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242908",
            "telephone_number": "310-209-2011",
            "fax_number": "310-209-2113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Bolton Boone Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751152041",
            "country_code": "US",
            "telephone_number": "214-946-5165",
            "fax_number": "972-296-2522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "SAM",
        "middle_name": "SEUNGHAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "F1333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00429299",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182297503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "208087232",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PPO",
            "identifier": "8AD481",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Junsoo Ahn
• Kyungja Ahn, L.AC
• Kyungwon Ahn
• Paul Ahn
• Phillip C. Ahn, M.D.
• Samuel Ahn, MD
• Seunghoon Ahn
• So Hee Ahn, MD
• Sol Ahn, CASE MANAGER
• Soo Hyun Ahn

• Vascular Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.

Verify at the official NPI Registry.