NPIMap

Individual provider Active NPI

Kenneth Paul Smith, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Mariposa, CA
National Provider Identifier
1285725937
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
G68554 Issued in CA
Practice address
5189 Hospital Rd
Mariposa, CA 95338-9524
Phone
(209) 966-3631
Fax
(209) 966-8438
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X G68554 CA Primary

Addresses

Primary practice location

5189 Hospital Rd
Mariposa, CA 95338-9524

Mailing address

PO Box 951
Los Banos, CA 93635-0951
Phone (209) 617-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071001000850 CA Practitioner - Emergency Medicine 4284729542 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Harvard Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John C Fremont Healthcare District 18 clinicians

Practice addresses (Care Compare)

5186 Hospital Rd
Mariposa, CA 95338-9524
Phone (209) 966-3631

5189 Hospital Rd
Mariposa, CA 95338-9524
Phone (209) 966-3631

Hospital & facility affiliations

  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Atta Home Healthcare Home health agency, Modesto, CA, CCN 559552
  • Compassionate Care Hospice Central California, LLC Hospice, Fresno, CA, CCN A01798
  • John C Fremont Healthcare District Hospital, Mariposa, CA, CCN 051304
  • Mercy Medical Center Hospital, Merced, CA, CCN 050444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G68554CAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John C Fremont Healthcare District Current Accepting new patients
John C Fremont Healthcare District CurrentSince Nov 1, 2009 Accepting new patients
John C Fremont Healthcare District CurrentSince Nov 1, 2009 Accepting new patients
Erx Hospitalist Group PC CurrentSince Nov 22, 2022 Accepting new patients
Erx Plus Professional Corporation CurrentSince Dec 20, 2022 Accepting new patients
Memorail Hospital of Los Banos Past Accepting new patients
John C. Fremont Healthcare District Past Accepting new patients
Sierra Rural Physicians, Inc. Emergency Medical Services Past Accepting new patients
Erx Plus Professional Corporation Past Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients

Locations

5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631

5189 Hospital Rd
#C
Mariposa, CA 95338
Phone (209) 966-3631

2000 N Classen Blvd
Ste 1200
Oklahoma City, OK 73106
Phone (866) 488-4558

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/fremont-d0489e1b

Organizations & group practices 13

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.

View all 13

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1285725937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936350951",
            "telephone_number": "209-617-3721",
            "fax_number": "209-966-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5189 HOSPITAL RD",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389524",
            "telephone_number": "209-966-3631",
            "fax_number": "209-966-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "G68554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mariposa, CA

Sources for this page

Verify at the official NPI Registry.