Individual provider Active NPI

Shavith Gabriel Samson, M.D.

  • Family Medicine Physician
  • Vista, CA
National Provider Identifier
1578097374
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C202426 Issued in CA
Practice address
130 Cedar Rd
Vista, CA 92083-5102
Phone
(760) 806-5600
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C202426 CA Primary

Addresses

Primary practice location

130 Cedar Rd
Vista, CA 92083-5102

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 806-5600

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
I20250725003599 CA Practitioner - Family Practice 9133490212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

130 Cedar Rd
Vista, CA 92083-5102
Phone (760) 806-5400

Hospital & facility affiliations

  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Advantage Health Systems Home health agency, San Diego, CA, CCN 058355
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C202426CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Family Medicine CurrentSince Aug 11, 2025 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Family Medicine Current Accepting new patients
Scripps Health CurrentSince Aug 11, 2025 Accepting new patients
Scripps Health Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

130 Cedar Rd
Ste 340
Vista, CA 92083

130 Cedar Rd
Vista, CA 92083
Phone (760) 806-5400

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1578097374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-806-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CEDAR RD",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835102",
            "telephone_number": "760-806-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "SHAVITH",
        "middle_name": "GABRIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C202426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.