Individual provider Active NPI

David Samuel Cohen, MD

  • Otolaryngology Physician
  • Pasadena, CA
National Provider Identifier
1679862502
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A143194 Issued in CA
Practice address
393 E Walnut St
3Rd Floor
Pasadena, CA 91188-0001
Phone
(310) 919-8763
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A143194 CA Primary

Addresses

Primary practice location

393 E Walnut St
3Rd Floor
Pasadena, CA 91188-0001

Mailing address

393 E Walnut St
3Rd Floor
Pasadena, CA 91188-0001
Phone (310) 919-8763

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20160927001045 CA Practitioner - Otolaryngology 6608178686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Southern California Keck School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143194CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 7, 2016 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 7, 2016 Accepting new patients

Locations

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1679862502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "3RD FLOOR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "310-919-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "3RD FLOOR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "310-919-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "DAVID",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A143194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.