Active NPI
Ryan Michael Smith, M.D.
- Pediatrics Physician
- Orange, CA
National Provider Identifier
1023452000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 091309990
- Practice address
- 505 S Main St
Orange, CA 92868-4509 - Phone
- (714) 456-5631
- Fax
- (714) 285-0389
- NPI assigned
- Apr 22, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 091309990 | CA | Primary |
Addresses
Primary practice location
505 S Main St
Orange, CA 92868-4509
Mailing address
505 S Main St
Orange, CA 92868-4509
Phone (714) 456-5631
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151001001675 | CA | Order and Referring Only - Pediatric Medicine | 3072821602 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091309990 | CA | MD | Student in an Organized Health Care Education/Training Program |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366588800000",
"number": "1023452000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684509",
"telephone_number": "714-456-5631",
"fax_number": "714-285-0389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684509",
"telephone_number": "714-456-5631",
"fax_number": "714-285-0389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "RYAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-22",
"last_updated": "2013-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "091309990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.