Active NPI
Dwayne Leonard Highsmith, DPM
- Podiatrist
- Vacaville, CA
National Provider Identifier
1619951613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3376
- Practice address
- 770 Mason St FL 2D
Vacaville, CA 95688 - Phone
- (707) 427-4900
- Fax
- (707) 454-5901
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E3376 | CA | Primary |
Addresses
Primary practice location
770 Mason St FL 2D
Vacaville, CA 95688
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071
Other practice location 1
2702 Low Ct
Fairfield, CA 94534-9771
Phone (707) 427-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E33760 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E3376 | CA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Napa Valley Foot & Ankle, Inc | Past | Accepting new patients | |
| Northbay Healthcare Group | Past | Accepting new patients |
Locations
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
770 Mason St
Fl 2D
Vacaville, CA 95688
Interoperability endpoints
- dhighsmithdpm32070@hisp.ehr.sutterhealth.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
-
- Foot & Ankle Surgery Podiatrist
- Vacaville, CA
- NPI 1891115838
-
- Multi-Specialty Clinic/Center
- Vacaville, CA
- NPI 1760534713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1619951613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228",
"telephone_number": "800-470-0071",
"fax_number": "707-454-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 MASON ST FL 2D",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95688",
"telephone_number": "707-427-4900",
"fax_number": "707-454-5901"
}
],
"practiceLocations": [
{
"address_1": "2702 Low Ct",
"address_purpose": "LOCATION",
"city": "Fairfield",
"state": "CA",
"postal_code": "945349771",
"country_code": "US",
"telephone_number": "707-427-4900",
"fax_number": "707-432-2607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HIGHSMITH",
"first_name": "DWAYNE",
"middle_name": "LEONARD",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E3376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E33760",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.