Individual provider Active NPI

Soumya Kambalapalli, MD

  • Internal Medicine Physician
  • Gardena, CA
National Provider Identifier
1558935908
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A194985 Issued in CA
Practice address
15822 S Vermont Ave
Unit-1
Gardena, CA 90247
Phone
(512) 300-5318
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351047692 MI
Internal Medicine Physician 207R00000X A194985 CA Primary

Addresses

Primary practice location

15822 S Vermont Ave
Unit-1
Gardena, CA 90247

Mailing address

15822 S Vermont Ave
Unit-1
Gardena, CA 90247
Phone (512) 300-5318

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
I20250221003225 CA Practitioner - Internal Medicine 0547660102 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A194985CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Hospitalist Medical Group, Inc Internal Medicine CurrentSince Dec 19, 2024 Accepting new patients

Locations

3700 South St
Lakewood, CA 90712
Phone (562) 424-2900

Organizations & group practices 1

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1558935908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15822 S VERMONT AVE",
            "address_2": "UNIT-1",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "512-300-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15822 S VERMONT AVE",
            "address_2": "UNIT-1",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "512-300-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBALAPALLI",
        "first_name": "SOUMYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351047692",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A194985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.