Individual provider Active NPI

Damien L Smith, MD

  • Urology Physician
  • Santa Cruz, CA
National Provider Identifier
1063603108
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A112593 Issued in CA
Practice address
2911 Chanticleer Ave
Santa Cruz, CA 95065
Phone
(831) 477-2350
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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 A112593 CA Primary

Addresses

Primary practice location

2911 Chanticleer Ave
Santa Cruz, CA 95065

Mailing address

2350 W El Camino Real FL 2
Mountain View, CA 94040-6203
Phone (831) 477-2350

Other practice location 1

1667 Dominican Way
Ste 234
Santa Cruz, CA 95065
Phone (831) 462-2825

Other practice location 2

1667 Dominican Way
Ste 234
Santa Cruz, CA 95065
Phone (831) 462-2825

Other identifiers 2

IdentifierTypeStateIssuer
1091430MedicaidLA
DV559VOtherCAMEDICARE

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
I20101115000672 CA Practitioner - Urology 1759412158 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Missouri, Columbia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816

2907 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

2911 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2350

2915 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection21
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112593CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 11, 2018 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients
SCL Health Montana Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3120 Kearney St
Fremont, CA 94538
Phone (650) 498-3600

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

715 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 934-7010

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2911 Chanticleer Ave
Santa Cruz, CA 95065
Phone (831) 477-2350

1667 Dominican Way
Ste 234
Santa Cruz, CA 95065
Phone (831) 476-3363

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: dsmith342281@hisp.ehr.sutterhealth.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1063603108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "831-477-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 CHANTICLEER AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-477-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1667 Dominican Way",
            "address_2": "Ste 234",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "95065",
            "country_code": "US",
            "telephone_number": "831-462-2825",
            "fax_number": "831-464-8603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1667 Dominican Way",
            "address_2": "Ste 234",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "95065",
            "country_code": "US",
            "telephone_number": "831-462-2825",
            "fax_number": "831-464-8603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAMIEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A112593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091430",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DV559V",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.