Individual provider Active NPI

Andrew Donald Smith, MD

  • Plastic Surgery Physician
  • Irvine, CA
National Provider Identifier
1174592778
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A65302 Issued in CA
Practice address
18 Endeavor Ste 102
Irvine, CA 92618-3180
Phone
(949) 653-7000
Fax
(949) 453-0553
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A65302 CA Primary

Addresses

Primary practice location

18 Endeavor Ste 102
Irvine, CA 92618-3180

Mailing address

18 Endeavor Ste 102
Irvine, CA 92618-3180
Phone (949) 653-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65302CAMDPlastic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1174592778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ENDEAVOR STE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183180",
            "telephone_number": "949-653-7000",
            "fax_number": "949-453-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ENDEAVOR STE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183180",
            "telephone_number": "949-653-7000",
            "fax_number": "949-453-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREW",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A65302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.