Active NPI
Peter Roy Smethurst, MD
- Critical Care Medicine (Internal Medicine) Physician
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- A77515
- Practice address
- 1010 W la Veta Ave Ste 750
Orange, CA 92868-4312 - Phone
- (714) 639-9401
- Fax
- (714) 919-8804
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A77515 | CA | |
| Pulmonary Disease Physician | 207RP1001X | A77515 | CA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | A77515 | CA | Primary |
Addresses
Primary practice location
1010 W la Veta Ave Ste 750
Orange, CA 92868-4312
Mailing address
1010 W la Veta Ave Ste 750
Orange, CA 92868-4312
Phone (714) 639-9401
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0003350 | Medicaid | CA | |
| 1912919804 | Medicaid | CA | |
| CG5665 | Other | CA | RAILROAD MEDICARE - GROUP PTAN |
| 1912919804 | Other | NPI - TYPE 2 | |
| P00855924 | Other | CA | RAILROAD MEDICARE - PROVIDER PTAN |
| W1514 | Other | CA | MEDICARE PTAN - TYPE 2 |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Albert Einstein College of Medicine of Yeshiva University, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 771-8000
Hospital & facility affiliations
- Providence St. Joseph Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A77515 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Hospitalist Network Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Providence St. Joseph Hospital | Hospital | Corporate Director | Jan 1, 2020 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Organizations & group practices 2
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Orange, CA
- NPI 1902313919
-
- Internal Medicine Physician
- Orange, CA
- NPI 1790880458
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orange, CA
- NPI 1912982216
-
- General Acute Care Hospital
- Orange, CA
- NPI 1558575746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1154485985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 W LA VETA AVE STE 750",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684312",
"telephone_number": "714-639-9401",
"fax_number": "714-919-8804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 W LA VETA AVE STE 750",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684312",
"telephone_number": "714-639-9401",
"fax_number": "714-919-8804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMETHURST",
"first_name": "PETER",
"middle_name": "ROY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A77515",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "A77515",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CA",
"license": "A77515",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0003350",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912919804",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE - GROUP PTAN",
"identifier": "CG5665",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI - TYPE 2",
"identifier": "1912919804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE - PROVIDER PTAN",
"identifier": "P00855924",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN - TYPE 2",
"identifier": "W1514",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.