Jerome Charles Smith, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A66490 Issued in CA

Practice address

651 1St St W
Suite H
Sonoma, CA 95476-7045

Phone

(707) 938-3870

Fax

(707) 938-3895

NPI assigned

Feb 8, 2006

Last updated

Oct 6, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Pediatric Medicine

Education

George Washington University School of Medicine, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmith106662@direct-ucsfmedicalcenter.org
• Direct secure messaging: jsmith627334@direct.ochin.org

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.

• Regents Univ of California UCSF

  dba UCSF Physician Group

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Prima Medical Foundation

  • Clinic/Center
  • Novato, CA
  • NPI 1811217946
  Medicare reassignment NPD
• Prima Medical Group, Inc.

  • Family Medicine Physician
  • San Rafael, CA
  • NPI 1154377489
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1295708675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 1ST ST W",
            "address_2": "SUITE H",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767045",
            "telephone_number": "707-938-3870",
            "fax_number": "707-938-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 1ST ST W",
            "address_2": "SUITE H",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767045",
            "telephone_number": "707-938-3870",
            "fax_number": "707-938-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEROME",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME83173",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A66490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC53855F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262135500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald M. Silver, PH.D.
• Merideth G Simpson, RN
• Jacqueline Singer, PH.D.
• Sleep Fit Medical
• Sarah Swanson Slough
• Melissa Smith
• Laila Solaris
• Michael A Sommer, MD
• Sonoma Acres Convalescent Hospital
• Sonoma Charter School

• Pediatrics Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.