Individual provider Active NPI

Matthew J. Smith, P.A.-C

  • Medical Physician Assistant
  • Rancho Mirage, CA
National Provider Identifier
1295774826
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18314 Issued in CA
Practice address
22032 Frank Sinatra Drive
Suite 100
Rancho Mirage, CA 92270
Phone
(760) 325-5588
Fax
(760) 322-7069
NPI assigned
Jun 6, 2006
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA18314 CA Primary

Addresses

Primary practice location

22032 Frank Sinatra Drive
Suite 100
Rancho Mirage, CA 92270

Mailing address

2285 Corporate Cir
Ste 200
Henderson, NV 89074-7759
Phone (702) 360-2763

Other identifiers 2

IdentifierTypeStateIssuer
P00346112OtherCARAILROAD MEDICARE
WPA18314AOtherCAINDIVIDUAL PTAN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000481 CA Practitioner - Physician Assistant 3072522556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

1457 Ford St
Suite 105
Redlands, CA 92373-3906
Phone (909) 793-2964

340 S Farrell Dr
Suite A205
Palm Springs, CA 92262-7931
Phone (760) 325-5588

72785 Frank Sinatra Dr
Suite 101
Rancho Mirage, CA 92270-3207
Phone (760) 969-5900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18314CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2023 Accepting new patients
J Robert West, M.D., Inc CurrentSince Oct 17, 2007 Accepting new patients
J. Robert West, M.D., Inc Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
J. Robert West, M.D., Inc Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

23521 Paseo de Valencia
Ste 302
Laguna Hills, CA 92653
Phone (949) 855-1007

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

340 S Farrell Dr
Ste A205
Palm Springs, CA 92262
Phone (760) 325-5588

72785 Frank Sinatra Dr
Ste 101
Rancho Mirage, CA 92270
Phone (760) 776-8637

1457 Ford St
Ste 105
Redlands, CA 92373
Phone (909) 793-2964

8990 Garfield St
Ste 3
Riverside, CA 92503
Phone (909) 689-4431

820 N Mountain Ave
Ste 235
Upland, CA 91786
Phone (909) 579-0700

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1295774826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22032 FRANK SINATRA DRIVE",
            "address_2": "SUITE 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-325-5588",
            "fax_number": "760-322-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00346112",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "WPA18314A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.