Organization Active NPI

Joel J. Smith, M.D. Inc.

  • Orthopaedic Surgery Physician
  • San Diego, CA
National Provider Identifier
1376778530
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
JOEL J. SMITH, M.D. INC.
Practice address
3750 Convoy Street
Suite 116
San Diego, CA 92111-3739
Phone
(858) 278-8110
Fax
(858) 810-7196
NPI assigned
May 18, 2009
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Dr. Joel J. Smith, M.D.NPI 1760411193
Title
President
Phone
(858) 278-8110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Trauma Physician 207XX0801X

Addresses

Primary practice location

3750 Convoy Street
Suite 116
San Diego, CA 92111-3739

Mailing address

3750 Convoy Street
Suite 116
San Diego, CA 92111-3739
Phone (858) 278-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091008000050 CA Part B Supplier - Clinic/Group Practice 2668518424 Receives reassigned benefits from 4 practitioners
Practice locations: Chula Vista, CA; San Diego, CA
O20110826000749 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2668518424 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

750 Medical Center Ct
Ste 6
Chula Vista, CA 91911
Phone (619) 658-2401

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1376778530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CONVOY STREET",
            "address_2": "SUITE 116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113739",
            "telephone_number": "858-278-8110",
            "fax_number": "858-810-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY STREET",
            "address_2": "SUITE 116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113739",
            "telephone_number": "858-278-8110",
            "fax_number": "858-810-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL J. SMITH, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-278-8110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.