Individual provider Active NPI

Kayla Samataro, NP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1629890983
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95031893 Issued in CA
Practice address
2104 N Verdugo Rd Apt B
Glendale, CA 91208-2551
Phone
(978) 877-0490
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95031893 CA Primary

Addresses

Primary practice location

2104 N Verdugo Rd Apt B
Glendale, CA 91208-2551

Mailing address

2104 N Verdugo Rd Apt B
Glendale, CA 91208-2551
Phone (978) 877-0490

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128002710 CA Practitioner - Nurse Practitioner 6901335520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Care Plus LLCGroup PAC ID 6709175912, 43 clinicians

Practice addresses (Care Compare)

215 W Pearl St
Pomona, CA 91768-3114
Phone (888) 256-3814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95031893CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Care Plus, LLC CurrentSince Jan 2, 2025 Accepting new patients

Locations

501 S Beach Blvd
Anaheim, CA 92804
Phone (714) 816-0540

1980 Felicita Rd
Escondido, CA 92025
Phone (750) 741-6109

9440 Citrus Ave
Fontana, CA 92335
Phone (909) 823-3481

215 W Pearl St
Pomona, CA 91768
Phone (909) 227-0750

8171 Magnolia Ave
Riverside, CA 92504
Phone (951) 657-3842

304 N Melrose Dr
Vista, CA 92083
Phone (760) 724-8222

5716 Corsa Ave
Ste 110
Westlake Village, CA 91362
Phone (214) 440-3671

4240 Blue Ridge Blvd
Ste 530
Kansas City, MO 64133
Phone (816) 291-4601

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1629890983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 N VERDUGO RD APT B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082551",
            "telephone_number": "978-877-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 N VERDUGO RD APT B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082551",
            "telephone_number": "978-877-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMATARO",
        "first_name": "KAYLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95031893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.