NPIMap

Individual provider Active NPI

Angela Beth Smith, CNP

  • Adult Health Nurse Practitioner
  • Eureka, CA
National Provider Identifier
1023368453
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
23313 Issued in CA
Practice address
1651 Myrtle Ave Ste C
Eureka, CA 95501-1495
Phone
(707) 599-6700
Fax
(888) 475-8698
NPI assigned
Sep 13, 2012
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 23313 CA Primary
General Practice Registered Nurse 163WG0000X 846580 CA

Addresses

Primary practice location

1651 Myrtle Ave Ste C
Eureka, CA 95501-1495

Mailing address

1651 Myrtle Ave Ste C
Eureka, CA 95501-1495
Phone (707) 599-6700

Other identifiers 1

IdentifierTypeStateIssuer
RN846580MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angela.smith.1@15882.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023001002 CA Practitioner - Nurse Practitioner 2769634435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1651 Myrtle Ave
Suite C
Eureka, CA 95501-1495
Phone (707) 362-8769

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.64 of 100Reported as individual
Quality
41.03
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: angela.smith.1@15882.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1023368453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 MYRTLE AVE STE C",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011495",
            "telephone_number": "707-599-6700",
            "fax_number": "888-475-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 MYRTLE AVE STE C",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011495",
            "telephone_number": "707-599-6700",
            "fax_number": "888-475-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELA",
        "middle_name": "BETH",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "23313",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "846580",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN846580",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.smith.1@15882.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1651 Myrtle Ave Ste C",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955011495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.