Individual provider Active NPI

Nellis Allan Smith, M.D.

  • Cardiovascular Disease Physician
  • E Palo Alto, CA
National Provider Identifier
1386678951
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C40443 Issued in CA
Practice address
1950 University Ave
Suite 160
E Palo Alto, CA 94303-2250
Phone
(650) 617-8100
Fax
(650) 327-2947
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X C40443 CA
Nuclear Cardiology Physician 207UN0901X C40443 CA
Cardiovascular Disease Physician 207RC0000X C40443 CA Primary

Addresses

Primary practice location

1950 University Ave
Suite 160
E Palo Alto, CA 94303-2250

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 617-8100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000711 CA Practitioner - Cardiovascular Disease (Cardiology) 1759308067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Medical Branch at Galveston, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200

1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone (650) 696-5400

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751
Phone (650) 369-5811

1950 University Ave
Suite 160
East Palo Alto, CA 94303-2285
Phone (650) 317-8100

2900 Whipple Ave
Redwood City, CA 94062-2851

301 Industrial Rd
San Carlos, CA 94070-2603
Phone (415) 600-1000

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C40443CAMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Nov 8, 2014 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Nov 8, 2014 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Sutter East Bay Medical Foundation Cardiovascular Disease Past Accepting new patients
Seton Medical Center Past Accepting new patients

Locations

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

880 Cass St
Ste 108
Monterey, CA 93940
Phone (650) 617-8100

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

770 Welch Rd
Ste 100
Palo Alto, CA 94304
Phone (415) 617-8100

2900 Whipple Ave
Ste 205
Redwood City, CA 94062
Phone (650) 363-5262

290 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 598-3160

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

301 Industrial Rd
San Carlos, CA 94070
Phone (650) 596-4000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: nsmith54987@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1386678951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-617-8100",
            "fax_number": "650-327-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 UNIVERSITY AVE",
            "address_2": "SUITE 160",
            "city": "E PALO ALTO",
            "state": "CA",
            "postal_code": "943032250",
            "telephone_number": "650-617-8100",
            "fax_number": "650-327-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NELLIS",
        "middle_name": "ALLAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "C40443",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "C40443",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C40443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.