Individual provider Active NPI

Steven C Smith, M.D.

  • Specialist
  • Freedom, CA
National Provider Identifier
1255419701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G22987 Issued in CA
Practice address
150 Carnation Dr Ste 5
Freedom, CA 95019-3132
Phone
(831) 728-5055
Fax
(831) 722-3641
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G22987 CA Primary

Addresses

Primary practice location

150 Carnation Dr Ste 5
Freedom, CA 95019-3132

Mailing address

509 Poppy Hill Rd
Watsonville, CA 95076-6302
Phone (831) 728-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101103000103 CA Practitioner - General SurgeryPractitioner - General Practice 3274634266 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G22987CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Feb 9, 2016 Accepting new patients
Salud Para la Gente CurrentSince Feb 9, 2016 Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255419701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 POPPY HILL RD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950766302",
            "telephone_number": "831-728-5055",
            "fax_number": "831-722-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CARNATION DR STE 5",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193132",
            "telephone_number": "831-728-5055",
            "fax_number": "831-722-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEVEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G22987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freedom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.