Kevin Scott Sampana De Leon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

113879 Issued in CA

Practice address

6041 Cadillac Ave
Los Angeles, CA 90034-1702

Phone

(833) 574-2273

NPI assigned

Sep 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Anesthesia on Demand - a Professional Nursing CorporationGroup PAC ID 1850780206, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 28)

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.

• Anesthesia on Demand - a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Glendale, CA
  • NPI 1003485384

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Amsurg Arcadia Anesthesia LP

  • Anesthesiology Physician
  • Arcadia, CA
  • NPI 1114291226
  Medicare reassignment NPD
• JP Anesthesia Inc

  • Certified Registered Nurse Anesthetist
  • Fontana, CA
  • NPI 1609590926

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Pacific Valley Medical Group

  • Anesthesiology Physician
  • Pasadena, CA
  • NPI 1851312862
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Samaritan Anesthesiology Medical Group

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1982792743
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1013409044
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1750800652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3758 BRESEE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064118",
            "telephone_number": "626-646-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "KEVIN SCOTT",
        "middle_name": "SAMPANA",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-12",
        "last_updated": "2021-12-06",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "826602",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "113879",
            "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": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jose De Leon
• Jose D De Leon
• Jose Roy C De Leon, RPT
• Karen De Leon
• Katherine De Leon
• Kristofer Andrew F De Leon, AGACNP
• Lara Camille Siman De Leon, NP
• Maria De Leon, PSY. D.
• Marina Berenice De Leon
• Niko KP De Leon

• Certified Registered Nurse Anesthetist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.