Individual provider Active NPI

Roberta J Smith, MD

  • Internal Medicine Physician
  • Pacific Palisades, CA
National Provider Identifier
1164532750
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G17205 Issued in CA
Practice address
970 Monument St
Suite 210
Pacific Palisades, CA 90272-3891
Phone
(310) 459-4321
Fax
(310) 459-5326
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G17205 CA Primary
Nephrology Physician 207RN0300X G17205 CA

Addresses

Primary practice location

970 Monument St
Suite 210
Pacific Palisades, CA 90272-3891

Mailing address

970 Monument St
Suite 210
Pacific Palisades, CA 90272-3891
Phone (310) 459-4321

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
I20100406000236 CA Practitioner - Internal MedicinePractitioner - Nephrology 2062548753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Perelman School of Med at the University of Pennsylvania, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1450 10TH St
Suite 302
Santa Monica, CA 90401-2831

Hospital & facility affiliations

  • Luxe Homecare, Inc Home health agency, Los Angeles, CA, CCN 059642
  • Providence Home Health la County South Home health agency, Torrance, CA, CCN 557447
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G17205CAMDInternal Medicine Physician
17205CAMDOccupational Therapist

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.

Hospital & facility affiliations 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1164532750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 MONUMENT ST",
            "address_2": "SUITE 210",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723891",
            "telephone_number": "310-459-4321",
            "fax_number": "310-459-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 MONUMENT ST",
            "address_2": "SUITE 210",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723891",
            "telephone_number": "310-459-4321",
            "fax_number": "310-459-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G17205",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G17205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

Verify at the official NPI Registry.