Individual provider Active NPI

Bernard Alan Smyle, M.D.

  • Pediatrics Physician
  • Ventura, CA
National Provider Identifier
1154347169
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G54868 Issued in CA
Practice address
1497 Vista del Mar Dr
Ventura, CA 93001-3733
Phone
(053) 404-6508
Fax
(805) 667-9015
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G54868 CA
Pediatrics Physician 208000000X G54868 CA Primary

Addresses

Primary practice location

1497 Vista del Mar Dr
Ventura, CA 93001-3733

Mailing address

PO Box 7667
Ventura, CA 93006-7667
Phone (805) 340-4650

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
I20200424002946 CA Practitioner - General PracticePractitioner - Pediatric Medicine 4981034329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54868CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc. Family Medicine Current Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Aug 1, 2021 Accepting new patients
Anaheim Urgent Care, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Community Memorial Health System Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

2100 S Euclid St
Anaheim, CA 92802
Phone (310) 542-0800

2968 E Florence Ave
Huntington Pk, CA 90255
Phone (323) 522-9500

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

11560 W Pico Blvd
Los Angeles, CA 90064
Phone (310) 477-8285

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336

11126 Chandler Blvd
North Hollywood, CA 91601
Phone (818) 432-8300

524 Colorado Ave
Santa Monica, CA 90401
Phone (310) 260-2917

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1154347169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7667",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930067667",
            "telephone_number": "805-340-4650",
            "fax_number": "805-667-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 VISTA DEL MAR DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013733",
            "telephone_number": "053-404-6508",
            "fax_number": "805-667-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLE",
        "first_name": "BERNARD",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G54868",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G54868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.