Individual provider Active NPI

Dianna Smith, NP-C

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1033654447
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95005439 Issued in CA
Practice address
10884 Santa Monica Blvd FL 3
Los Angeles, CA 90025-7638
Phone
(310) 446-4400
Fax
(310) 446-4408
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95005439 CA Primary
Registered Nurse 163W00000X 841765 CA

Addresses

Primary practice location

10884 Santa Monica Blvd FL 3
Los Angeles, CA 90025-7638

Mailing address

6640 Kentwood Bluffs Dr
Los Angeles, CA 90045-1259

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180515000747 CA Practitioner - Nurse Practitioner 4284998576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.03 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
33.57

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J M Geiss DO Apc CurrentSince Oct 30, 2023 Accepting new patients
Ocean Point Physical Therapy Inc CurrentSince Jun 2, 2024 Accepting new patients

Locations

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

410 Torrance Blvd
Redondo Beach, CA 90277
Phone (310) 540-8333

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1033654447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 KENTWOOD BLUFFS DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10884 SANTA MONICA BLVD FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257638",
            "telephone_number": "310-446-4400",
            "fax_number": "310-446-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANNA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005439",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "841765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.