Individual provider Active NPI

Jason Buddika Samarasena, M.D.

  • Gastroenterology Physician
  • Orange, CA
National Provider Identifier
1629253364
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A100124 Issued in CA
Practice address
101 The City Dr S
Building 200, Suite 720
Orange, CA 92868-3201
Phone
(714) 456-6693
Fax
(714) 456-8874
NPI assigned
Dec 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A100124 CA Primary
Internal Medicine Physician 207R00000X A100124 CA

Addresses

Primary practice location

101 The City Dr S
Building 200, Suite 720
Orange, CA 92868-3201

Mailing address

363 Newport Ave
Unit 317
Long Beach, CA 90814-2661
Phone (562) 438-2330

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
I20110628000443 CA Practitioner - Internal MedicinePractitioner - Gastroenterology 6103004874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy123
Upper gastrointestinal (GI) endoscopy for acid reflux373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100124CAMDPediatric Dentist
A100124CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Gastroenterology CurrentSince May 25, 2011 Accepting new patients
UC Regents Current Accepting new patients
UC Regents CurrentSince May 25, 2011 Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
UC Regents Internal Medicine Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 22
Orange, CA 92868
Phone (888) 717-4463

101 The City Dr S
Bldg 200
Orange, CA 92868
Phone (714) 456-5922

101 The City Dr S
Bldg 22C
Orange, CA 92868
Phone (714) 456-5308

Organizations & group practices 7

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 2

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": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1629253364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 NEWPORT AVE",
            "address_2": "UNIT 317",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142661",
            "telephone_number": "562-438-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "BUILDING 200, SUITE 720",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6693",
            "fax_number": "714-456-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARASENA",
        "first_name": "JASON",
        "middle_name": "BUDDIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-31",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A100124",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.