Individual provider Active NPI

Peter Farouk Samaan, MD

  • Family Medicine Physician
  • West Covina, CA
National Provider Identifier
1750582136
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A96615 Issued in CA
Practice address
1300 S Sunset Ave
West Covina, CA 91790-3342
Phone
(626) 960-6999
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A96615 CA Primary

Addresses

Primary practice location

1300 S Sunset Ave
West Covina, CA 91790-3342

Mailing address

965 Manor Way
Corona, CA 92882
Phone (951) 768-0209

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
I20070823000746 CA Practitioner - Family Practice 4385736115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

5850 S Main St
Los Angeles, CA 90003-1215
Phone (323) 897-6000

Hospital & facility affiliations

  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376
  • Lac/Rancho Los Amigos National Rehabilitation Ctr Hospital, Downey, CA, CCN 050717

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
John R Shaw MD Medical Corporation Family Medicine Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

Interoperability endpoints

  • Direct secure messaging: peter.samaan.1@30520.direct.athenahealth.com
  • Direct secure messaging: peter.samaan.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 2

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1750582136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 MANOR WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92882",
            "telephone_number": "951-768-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903342",
            "telephone_number": "626-960-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAAN",
        "first_name": "PETER",
        "middle_name": "FAROUK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.