SAM SEUNGHAE AHN, MD — NPI 1497783831 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery

CMS-1500 Box 24J / 33a • NPI

1497783831

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2086S0129X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery

Box 32 Service Location & ZIP+4

1082 GLENDON AVE, LOS ANGELES, CA, 90024-2908

✓ 9-Digit EDI 837 ZIP+4 (90024-2908)

Practice Phone & Referral Fax

(310) 209-2011

Fax: (310) 209-2113

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1497783831 (SAM SEUNGHAE AHN, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1497783831` (NPI-1 Individual Practitioner)
Provider / Legal Name	SAM SEUNGHAE AHN, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery NUCC Code: `2086S0129X` (N/A)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1082 GLENDON AVE, LOS ANGELES, CA, 90024-2908
Practice Telephone / Fax	Tel: (310) 209-2011 \| Fax: (310) 209-2113
Administrative Mailing Address	1082 GLENDON AVE, LOS ANGELES, CA, 90024-2908
Enumeration & Last Sync	Enumerated: 2006-06-28 \| CMS Record Updated: 2025-08-14

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1082 GLENDON AVE, LOS ANGELES, CA, 90024-2908

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Plain-English Taxonomy & CMS Crosswalk (2086S0129X)

What Does Taxonomy Code 2086S0129X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2086S0129X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 76 (Physician/Peripheral Vascular Disease) • CMS Code 77 (Physician/Vascular Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SAM SEUNGHAE AHN, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2086S0129X` — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery	State: TX \| License: `F1333` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SAM SEUNGHAE AHN, MD (NPI #1497783831)