Individual provider Active NPI

Nydia Ekasumara

  • Anesthesiology Physician
  • Torrance, CA
National Provider Identifier
1922485366
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A162188 Issued in CA
Practice address
4101 Torrance Blvd
Torrance, CA 90503-4607
Phone
(310) 540-7676
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A162188 CA Primary

Addresses

Primary practice location

4101 Torrance Blvd
Torrance, CA 90503-4607

Mailing address

6600 Warner Ave Unit 241
Huntington Beach, CA 92647-5281

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
I20200723001355 CA Practitioner - Anesthesiology 9739503723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Icahn School of Medicine at Mount Sinai, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Socal Anesthesia Solutions IncGroup PAC ID 0042607426, 46 clinicians

Practice addresses (Care Compare)

18111 Brookburst St
Fountain Valley, CA 92708-6728
Phone (714) 378-7000

Hospital & facility affiliations

  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162188CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Anesthesia Medical Group Inc. Anesthesiology CurrentSince Aug 3, 2020 Accepting new patients
Socal Anesthesia Solutions, Inc Anesthesiology CurrentSince Aug 1, 2023 Accepting new patients

Locations

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

18111 Brookhurst St
Fountain Vly, CA 92708
Phone (714) 369-1100

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Interoperability endpoints

  • Direct secure messaging: nekasumara751386@direct.memorialcare.org

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 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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1922485366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 WARNER AVE UNIT 241",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034607",
            "telephone_number": "310-540-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKASUMARA",
        "first_name": "NYDIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A162188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.