Susan J. Smith, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G73621 Issued in CA

Practice address

2415 University Ave Ste 301
East Palo Alto, CA 94303-1148

Phone

(650) 363-4030

Fax

(650) 328-6834

NPI assigned

Mar 26, 2007

Last updated

Dec 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

University of North Dakota School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment Care Compare group NPD
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• San Mateo County

  dba Jefferson Union High School District (JUHSD) TDS

  • Adolescent and Children Mental Health Clinic/Center
  • Pacifica, CA
  • NPI 1700978574
  NPD
• San Mateo County

  dba Community Counseling Center

  • Community/Behavioral Health Agency
  • East Palo Alto, CA
  • NPI 1710086301

  Psychiatry

  NPD
• Mark David Levine M.D. Professional Corporation

  dba Mindpath Health

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1154697944
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1194843607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE STE 301",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031148",
            "telephone_number": "650-363-4030",
            "fax_number": "650-328-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE STE 301",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031148",
            "telephone_number": "650-363-4030",
            "fax_number": "650-328-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G73621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in East Palo Alto, CA
• Providers in East Palo Alto, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.