1. Home
  2. Directory
  3. California
  4. Anaheim
  5. Nurse Practitioner
  6. NPI Profile

MR. RICHARD GABRIEL SAMEDRA PMHNP-BC
NPI 1093561904
Nurse Practitioner - Psychiatric/Mental Health in Anaheim, CA

Active since April 30, 2024PECOS EnrolledAccepts Medicare Assignment
1720 W BALL RD STE 4C, ANAHEIM, CA 92804(714) 683-1472(714) 683-1473 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 3, 2025, Jul 22, 2024, Apr 30, 2024 (3 updates tracked since 2024).

About Mr. Richard Gabriel Samedra Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RICHARD GABRIEL SAMEDRA PMHNP-BC (NPI 1093561904) is an individual psychiatric/mental health provider in Anaheim, California, licensed in California (95030301) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Placentia, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1093561904
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. RICHARD GABRIEL SAMEDRACredential: PMHNP-BC
Location Address1720 W BALL RD STE 4CAnaheim, CA 92804-5591
Mailing Address123 Orange Grove AvePlacentia, CA 92870-4848 · (949) 566-4308 · Fax (714) 683-1473
Phone(714) 683-1472
Fax(714) 683-1473
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateApril 30, 2024
Last NPPES UpdateApril 17, 20253 updates tracked since enumeration
NPPES CertifiedApril 17, 2025
✔ NPI 1093561904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95030301
1720 W BALL RD STE 4C, Anaheim, CA 92804
Open in Google Maps ↗

Secondary Practice Location 1

Location 1123 Orange Grove AvePlacentia, CA 92870-4848 · Phone (949) 566-4308

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Richard Gabriel Samedra Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163957176
PECOS Enrollment IDI20241127004205
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Richard Samedra reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Coast Medical, PC
Same address
Psychiatry
1720 W BALL RD STE 4C
Anaheim, CA 92804
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Coast Medical P C
  • 24 clinicians in this Medicare group
NPI 1780435628 (626) 429-0088
Mental Health And Nursing PC
1.7 mi
Psychiatric/Mental Health
421 N BROOKHURST ST STE 119
Anaheim, CA 92801
  • Reassigned Medicare billing, California enrollment
  • 40 clinicians in this Medicare group
NPI 1528693579 (714) 361-0898
Renewed Medical Group, A Professional Medical Corporation
1.7 mi
Psychiatry
421 N BROOKHURST ST STE 128
Anaheim, CA 92801
  • Reassigned Medicare billing, California enrollment
  • 26 clinicians in this Medicare group
NPI 1922785690 (714) 361-0898

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINA CHERIKI RN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (714) 683-1472
RAINBOW A TARUMOTO AGACNP
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (714) 683-1472
SARA EQUIHUA NP
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (714) 683-1472
DENNIS TAM MINH LY NP
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (714) 683-1472
JACKSON TEA MSN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (714) 683-1472
COAST MEDICAL, PC
Psychiatry & Neurology (Psychiatry)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (626) 429-0088
MS. VIVIENNE WEIJU PENG PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1720 W BALL RD STE 4C
ANAHEIM, CA 92804
Orange County (951) 598-7885

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Samedra's NPI number?

The NPI number for Richard Samedra is 1093561904. It was assigned to this individual provider in the NPPES registry on April 30, 2024.

Where is Richard Samedra located?

Richard Samedra practices at 1720 W Ball Rd Ste 4C, Anaheim, CA 92804. The listed phone number is (714) 683-1472.

What is Richard Samedra's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Richard Samedra enrolled in Medicare?

Yes. Richard Samedra is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Richard Samedra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Samedra reassigns Medicare benefits to 3 organizations: Coast Medical, PC (Anaheim, CA), Mental Health And Nursing PC (Anaheim, CA) and Renewed Medical Group, A Professional Medical Corporation (Anaheim, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Richard Samedra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Richard Samedra was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.