Individual provider Active NPI

Samir E Hage, D.O.

  • Obstetrics & Gynecology Physician
  • Redlands, CA
National Provider Identifier
1821059924
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A7233 Issued in CA
Practice address
255 Terracina Blvd
Suite 202
Redlands, CA 92373-4870
Phone
(909) 748-6065
Fax
(909) 748-6095
NPI assigned
Mar 29, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A7233 CA Primary

Addresses

Primary practice location

255 Terracina Blvd
Suite 202
Redlands, CA 92373-4870

Mailing address

255 Terracina Blvd
Suite 202
Redlands, CA 92373-4870
Phone (909) 748-6065

Other identifiers 1

IdentifierTypeStateIssuer
20A7233MedicaidCA

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
I20040825000457 CA Practitioner - Obstetrics/Gynecology 8022082288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
College of Osteo Med of the Pacific at Pomona, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samir E Hage DO IncGroup PAC ID 7113991373, 3 clinicians

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 202
Redlands, CA 92373-4870
Phone (909) 936-0600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8233CAMDAnesthesiology Physician
20A7233CAMDObstetrics & Gynecology Physician
7233CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Jun 29, 2016 Accepting new patients
Samir E. Hage, D.O., Inc. Obstetrics & Gynecology CurrentSince Jun 14, 2004 Accepting new patients
Icon Medical Group Inc Obstetrics & Gynecology Current Accepting new patients
Redlands Community Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Arrowhead Neurosurgical Medical Group, Inc. Past Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

101 E Redlands Blvd
Ste 106
Redlands, CA 92373
Phone (818) 484-8611

255 Terracina Blvd
Ste 202
Redlands, CA 92373
Phone (909) 748-6065

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: seh102pcs@m1441.primeclinicalsystems.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1821059924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD",
            "address_2": "SUITE 202",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-748-6065",
            "fax_number": "909-748-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD",
            "address_2": "SUITE 202",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-748-6065",
            "fax_number": "909-748-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "SAMIR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A7233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20A7233",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.