Individual provider Active NPI

Edward Smitaman, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1477720092
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A119696 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(858) 246-1021
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X A119696 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

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
I20120712000429 CA Practitioner - Diagnostic Radiology 1951566256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Garden View Rd
Suite 210
Encinitas, CA 92024-2475
Phone (800) 926-8273

1415 Ross Ave
El Centro, CA 92243-4306
Phone (800) 926-8273

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

200 W Arbor Dr
San Diego, CA 92103-1911

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

447 N El Camino Real
Encinitas, CA 92024-1302
Phone (858) 657-7000

495 E Birch St
Calexico, CA 92231-2374
Phone (800) 926-5273

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-8273

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273

9400 Campus Point Dr
La Jolla, CA 92093-1350
Phone (800) 926-8273

9415 Campus Point Dr
La Jolla, CA 92093-1350
Phone (800) 926-8273

9434 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

9452 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A119696CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Jan 12, 2015 Accepting new patients
Regents of the University of California Ucsd Department of Radiology Diagnostic Radiology CurrentSince Oct 1, 2014 Accepting new patients
UC San Diego Health Community Group CurrentSince Jan 14, 2019 Accepting new patients
Scripps Health CurrentSince Jan 12, 2015 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Jul 1, 2012 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

9452 Medical Center Dr
La Jolla, CA 92037
Phone (858) 246-2016

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

8929 University Center Ln
San Diego, CA 92122
Phone (855) 543-0333

4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175

330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

200 W Arbor Dr
Ste I505
San Diego, CA 92103

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

8929 University Center Ln
Ste 101
San Diego, CA 92122
Phone (858) 457-4227

408 Dickinson St
San Diego, CA 92103
Phone (619) 471-0513

Interoperability endpoints

  • Direct secure messaging: esmitaman276751@sharphealthcare.direct-ci.com

Organizations & group practices 7

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 5

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1477720092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "858-246-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITAMAN",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A119696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.