Individual provider Active NPI

Charles Barton Smoot, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1245490358
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A97036 Issued in CA
Practice address
1809 National Avenue
San Diego, CA 92113-2196
Phone
(619) 515-2300
Fax
(619) 234-2447
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A97036 CA Primary

Addresses

Primary practice location

1809 National Avenue
San Diego, CA 92113-2196

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2323

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
I20100921001541 CA Practitioner - Family Practice 3476679994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

1000 Euclid Ave
National City, CA 91950-3856
Phone (619) 515-2399

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

3514 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

3544 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

5160 Federal Blvd
San Diego, CA 92105-5429
Phone (619) 515-2454

8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone (619) 515-2555

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97036CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Jun 28, 2010 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jun 28, 2010 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

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 1

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1245490358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2323",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVENUE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132196",
            "telephone_number": "619-515-2300",
            "fax_number": "619-234-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "CHARLES",
        "middle_name": "BARTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.