Individual provider Active NPI

Paul Lawrence Smith, MD

  • Dermatology Physician
  • Santa Monica, CA
National Provider Identifier
1063480473
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A21571 Issued in CA
Practice address
2001 Santa Monica Blvd
990W
Santa Monica, CA 90404-2103
Phone
(310) 829-4484
Fax
(310) 829-4481
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A21571 CA Primary
Procedural Dermatology Physician 207NS0135X A21571 CA
Dermatopathology Physician 207ND0900X A21571 CA

Addresses

Primary practice location

2001 Santa Monica Blvd
990W
Santa Monica, CA 90404-2103

Mailing address

2001 Santa Monica Blvd
990W
Santa Monica, CA 90404-2102
Phone (310) 829-4484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of California, Geffen School of Medicine, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 Santa Monica Blvd
990W
Santa Monica, CA 90404-2155

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1634
Removal or shaving of skin growth1-10
Skin biopsy707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A21571CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Monica Dermatology Group Dermatology CurrentSince Sep 1, 2017 Accepting new patients

Locations

2001 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 829-3401

2001 Santa Monica Blvd
Ste 990W
Santa Monica, CA 90404
Phone (310) 829-4481

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e1A5O_wfjp6bxazsKQMUgQtMMK_UwF9x/

Organizations & group practices 1

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1063480473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "990W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-829-4484",
            "fax_number": "310-829-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "990W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042103",
            "telephone_number": "310-829-4484",
            "fax_number": "310-829-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAUL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A21571",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A21571",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A21571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.