NPIMap

Organization Active NPI

Integrated Pain Specialists of Southern California, Inc.

Doing business as Kevin S. Smith, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
National Provider Identifier
1639184344
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
INTEGRATED PAIN SPECIALISTS OF SOUTHERN CALIFORNIA, INC.
Doing business as
Kevin S. Smith, M.D.
Practice address
7525 Linda Vista Rd Ste C
San Diego, CA 92111-5344
Phone
(619) 398-2988
Fax
(619) 398-2987
NPI assigned
Jul 30, 2006
Last updated
Jan 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Kevin S Smith, MDNPI 1457388225
Title
President
Phone
(619) 398-2988

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
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

7525 Linda Vista Rd Ste C
San Diego, CA 92111-5344

Mailing address

7525 Linda Vista Rd Ste C
San Diego, CA 92111-5344
Phone (619) 398-2988

Other identifiers 1

IdentifierTypeStateIssuer
G70647OtherCAPHYSICIAN MEDICAL LICENSE

Other names 1

  • Kevin S. Smith, M.D. Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070502000609 CA Part B Supplier - Clinic/Group Practice 3577669860 Receives reassigned benefits from 3 practitioners
Practice locations: San Diego, CA
O20120828000569 CA DME Supplier - Physician - Interventional Pain Management 3577669860 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

7910 Frost St
Ste 280
San Diego, CA 92123
Phone (619) 398-2988

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 9

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1639184344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 LINDA VISTA RD STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115344",
            "telephone_number": "619-398-2988",
            "fax_number": "619-398-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 LINDA VISTA RD STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115344",
            "telephone_number": "619-398-2988",
            "fax_number": "619-398-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PAIN SPECIALISTS OF SOUTHERN CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-398-2988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN MEDICAL LICENSE",
            "identifier": "G70647",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin S. Smith, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 3, 2024; 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.