Individual provider Active NPI

Briant W Smith, MD

  • Orthopaedic Surgery Physician
  • Santa Rosa, CA
National Provider Identifier
1639253628
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G61163 Issued in CA
Practice address
3883 Airway Dr
Suite 165
Santa Rosa, CA 95403-1670
Phone
(707) 521-7799
Fax
(707) 521-8951
NPI assigned
Oct 25, 2006
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G61163 CA Primary

Addresses

Primary practice location

3883 Airway Dr
Suite 165
Santa Rosa, CA 95403-1670

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (707) 521-7799

Other identifiers 1

IdentifierTypeStateIssuer
00G611630MedicaidCA

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
I20110208000114 CA Practitioner - Orthopedic Surgery 2961682000 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G61163CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Mar 3, 2024 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

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

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

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

795 El Camino Real
#1112
Palo Alto, CA 94301

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

131 Stony Cir
Ste 1600
Santa Rosa, CA 95401
Phone (707) 541-7700

3569 Round Barn Cir
Santa Rosa, CA 95403

3883 Airway Dr
Santa Rosa, CA 95403
Phone (415) 751-1817

3883 Airway Dr
Ste 100
Santa Rosa, CA 95403
Phone (707) 521-4480

3883 Airway Dr
Ste 165
Santa Rosa, CA 95403
Phone (707) 521-7799

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

4700 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 526-3360

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1639253628",
    "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": "707-521-7799",
            "fax_number": "707-521-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "SUITE 165",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-521-7799",
            "fax_number": "707-521-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRIANT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G61163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G611630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.