Individual provider Active NPI

Lawrence Smyle, P.T

  • Physical Therapist
  • South San Francisco, CA
National Provider Identifier
1659434900
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CA9873 Issued in CA
Practice address
443 Grand Ave
South San Francisco, CA 94080-3635
Phone
(650) 588-9668
Fax
(415) 839-3077
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA9873 CA Primary

Addresses

Primary practice location

443 Grand Ave
South San Francisco, CA 94080-3635

Mailing address

443 Grand Ave
South San Francisco, CA 94080-3635
Phone (650) 588-9668

Other identifiers 1

IdentifierTypeStateIssuer
611781300OtherCAACS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140108000203 CA Practitioner - Physical Therapist in Private Practice 6901034404 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: South San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Snehshakti CorporationGroup PAC ID 8123481967, 3 clinicians

Practice addresses (Care Compare)

443 Grand Ave
South San Francisco, CA 94080-3635
Phone (650) 588-9668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CA9873CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Snehshakti Corporation Physical Therapist CurrentSince May 22, 2023 Accepting new patients

Locations

443 Grand Ave
South San Francisco, CA 94080
Phone (650) 558-9668

Practitioners & affiliated clinicians

Practitioners 2

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1659434900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 GRAND AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803635",
            "telephone_number": "650-588-9668",
            "fax_number": "415-839-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 GRAND AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803635",
            "telephone_number": "650-588-9668",
            "fax_number": "415-839-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLE",
        "first_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "CA9873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "611781300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.