Samuel Uchechukwu Chilaka, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95017483 Issued in CA

Practice address

1000 Vale Terrace Dr
Vista, CA 92084-5218

Phone

(844) 308-5003

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shasta Community Health CenterGroup PAC ID 3870579816, 63 clinicians

Lifeline Walk in Medical and Mental Health Nursing Clinic IncGroup PAC ID 0749727147, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: samuel.chilakanp.p1@direct.vistacommunityclinic.nextgenshare.com
• FHIR API: https://fhir4.healow.com/fhir/r4/FHBGDD/Endpoint/FHBGDD
• Direct secure messaging: samuel.chilakapmhnp.p1@direct.schc.nextgenshare.com

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.

• Lifeline Walk in Medical & Mental Health Nursing Clinic, Inc

  • Nurse Practitioner
  • Torrance, CA
  • NPI 1134963309
  Medicare reassignment Care Compare group NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1114533171
  Medicare reassignment Care Compare group
• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1356815542
  NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1891710638
  NPD

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1679140644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 THORNBURGH PL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905041116",
            "telephone_number": "323-327-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "844-308-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3949 Thornburgh Pl",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905041116",
            "country_code": "US",
            "telephone_number": "323-327-3167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 W 190th St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484305",
            "country_code": "US",
            "telephone_number": "310-515-8113",
            "fax_number": "310-538-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILAKA",
        "first_name": "SAMUEL",
        "middle_name": "UCHECHUKWU",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Susan Chennell, PT
• Deborah Cherniak, RN
• Cherry Chiropractic
• Cheryl L Gilbert LMFT
• Alan Chien, DDS
• Rodney Kevin Chin, PHARM.D.
• Sandra Choi
• Christina Marie Chorazy, PA-C
• David Noyce Chrisman Jr., DDS
• Christian Bentley, M.D. a Professional Corporation

• Psychiatric/Mental Health Nurse Practitioner in Vista, CA
• Providers in Vista, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.