Individual provider Active NPI

Samuel J Thurber, MD

  • Emergency Medicine Physician
  • West Covina, CA
National Provider Identifier
1699729855
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A65610 Issued in CA
Practice address
1115 S Sunset Ave
West Covina, CA 91790-3940
Phone
(626) 814-2534
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A65610 CA Primary

Addresses

Primary practice location

1115 S Sunset Ave
West Covina, CA 91790-3940

Mailing address

8808 Thrasher Ave
Los Angeles, CA 90069-1238
Phone (310) 592-2514

Other identifiers 1

IdentifierTypeStateIssuer
00A656100MedicaidCA

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
I20050523000726 CA Practitioner - Emergency Medicine 9931141769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Columbia University College of Physicians and Surgeons, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Hospitalist Medical Group IncGroup PAC ID 8921308636, 30 clinicians

Practice addresses (Care Compare)

1680 E 120TH St
Los Angeles, CA 90059-3026
Phone (424) 338-8144

Hospital & facility affiliations

  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65610CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vep MLK Emergency Medical Group Inc Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Capital Hospitalist Medical Group Inc Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Michael S. Agron, M.D., Inc. Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Golden State Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

Organizations & group practices 4

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 1

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1699729855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 THRASHER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691238",
            "telephone_number": "310-592-2514",
            "fax_number": "310-909-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-814-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURBER",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A65610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A656100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.