Individual provider Active NPI

Robert B Smith, MD

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1063432607
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A21246 Issued in CA
Practice address
10833 Le Conte Ave.
Los Angeles, CA 90095-3075
Phone
(310) 794-7700
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A21246 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave.
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 794-7700

Other identifiers 1

IdentifierTypeStateIssuer
00A212460MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728000327 CA Practitioner - Urology 9638107915 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A21246CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Urology CurrentSince Sep 1, 1995 Accepting new patients
UCLA Medical Group Urology Past Accepting new patients
UCLA Urology Associates Urology Past Accepting new patients
Jacob Rajfer M D Inc Urology Past Accepting new patients

Locations

200 Medical Plz
Ste 140
Los Angeles, CA 90095
Phone (310) 206-1434

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

200 UCLA Medical Plz
Ste 140
Los Angeles, CA 90095
Phone (310) 206-8164

10833 Le Conte Ave
Ste 140
Los Angeles, CA 90095
Phone (310) 825-9273

10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

10833 Le Conte Ave
Ste B7240
Los Angeles, CA 90095

10833 Le Conte Ave
#200
Los Angeles, CA 90095
Phone (310) 825-9273

Organizations & group practices 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1063432607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-794-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-794-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A21246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A212460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.