Organization Active NPI

Sam Elsheikh MD Inc

  • Gastroenterology Physician
  • La Mesa, CA
National Provider Identifier
1871896118
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SAM ELSHEIKH MD INC
Practice address
5565 Grossmont Center Dr.
BLDG 1 Ste 227
La Mesa, CA 91942-3026
Phone
(619) 464-1138
Fax
(619) 464-4987
NPI assigned
Dec 8, 2010
Last updated
Dec 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Husam Elsheikh, M.D.NPI 1356427512
Title
Phyician
Phone
(619) 464-1138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5565 Grossmont Center Dr.
BLDG 1 Ste 227
La Mesa, CA 91942-3026

Mailing address

5565 Grossmont Center Dr.
BLDG 1 Ste 227
La Mesa, CA 91942-3026
Phone (619) 464-1138

Other identifiers 1

IdentifierTypeStateIssuer
00A416510MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221000256 CA Part B Supplier - Clinic/Group Practice 0749478535 Receives reassigned benefits from 1 practitioner
Practice locations: La Mesa, CA

National Provider Directory

National Provider Directory

Locations

5565 Grossmont Center Dr
Ste 227
La Mesa, CA 91942
Phone (619) 464-1138

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1871896118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR.",
            "address_2": "BLDG 1 STE 227",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423026",
            "telephone_number": "619-464-1138",
            "fax_number": "619-464-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR.",
            "address_2": "BLDG 1 STE 227",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423026",
            "telephone_number": "619-464-1138",
            "fax_number": "619-464-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM ELSHEIKH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "ELSHEIKH",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "PHYICIAN",
        "authorized_official_telephone_number": "619-464-1138",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A416510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.