Organization Active NPI

Szmidt a Professional Medical Corp

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1467558718
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SZMIDT A PROFESSIONAL MEDICAL CORP
Practice address
12395 El Camino Real
#100
San Diego, CA 92130-3083
Phone
(858) 259-5655
Fax
(858) 259-5638
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Dr. Maria Jolanta Szmidt, M.D.NPI 1033221171
Title
Physician/Ceo
Phone
(858) 259-5655

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12395 El Camino Real
#100
San Diego, CA 92130-3083

Mailing address

12395 El Camino Real
Suite #100
San Diego, CA 92130-3083
Phone (858) 259-5655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070222000703 CA Part B Supplier - Clinic/Group Practice 4183726045 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1467558718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL",
            "address_2": "SUITE #100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303083",
            "telephone_number": "858-259-5655",
            "fax_number": "858-259-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL",
            "address_2": "#100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303083",
            "telephone_number": "858-259-5655",
            "fax_number": "858-259-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SZMIDT A PROFESSIONAL MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "SZMIDT",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "JOLANTA",
        "authorized_official_title_or_position": "PHYSICIAN/CEO",
        "authorized_official_telephone_number": "858-259-5655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 12, 2023; 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.