Individual provider Active NPI

Michael Sean Sampson, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1568466100
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G84548 Issued in CA
Practice address
3919 Beverly Blvd Ste 203
Los Angeles, CA 90004-3432
Phone
(323) 953-2956
Fax
(323) 913-2588
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X G84548 CA
Internal Medicine Physician 207R00000X G84548 CA Primary

Addresses

Primary practice location

3919 Beverly Blvd Ste 203
Los Angeles, CA 90004-3432

Mailing address

3919 Beverly Blvd Ste 203
Los Angeles, CA 90004-3432
Phone (323) 953-2956

Other identifiers 1

IdentifierTypeStateIssuer
00G845481MedicaidCA

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
I20100927001183 CA Practitioner - Internal Medicine 5294851234 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3919 Beverly Blvd
Suite 203
Los Angeles, CA 90004-3432
Phone (323) 953-2956

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G84548CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Speech and Language Therapy Center Inc Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1568466100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 BEVERLY BLVD STE 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043432",
            "telephone_number": "323-953-2956",
            "fax_number": "323-913-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 BEVERLY BLVD STE 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043432",
            "telephone_number": "323-953-2956",
            "fax_number": "323-913-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "MICHAEL",
        "middle_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G84548",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G84548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G845481",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.