Active NPI
Andrew M Smythe, DO
- Family Medicine Physician
- Santa Cruz, CA
National Provider Identifier
1669891479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A15748
- Practice address
- 2018 Mission St
Santa Cruz, CA 95060-5218 - Phone
- (831) 706-2220
- Fax
- (831) 425-2034
- NPI assigned
- Apr 8, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PG167651 | OR | |
| Family Medicine Physician | 207Q00000X | 20A15748 | CA | Primary |
Addresses
Primary practice location
2018 Mission St
Santa Cruz, CA 95060-5218
Mailing address
3400 Data Dr
Attn Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102001430 | CA | Practitioner - Family Practice | 5698031938 | Practice locations: Santa Cruz, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
740 Front St
Suite 345B
Santa Cruz, CA 95060-4561
Phone (408) 313-9779
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A15748 | CA | MD | Family Medicine Physician |
| PG167651 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health | Past | Accepting new patients |
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": "1396915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509580800000",
"number": "1669891479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"address_2": "ATTN CREDENTIALING/PAYER ENROLLMENT",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2018 MISSION ST",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950605218",
"telephone_number": "831-706-2220",
"fax_number": "831-425-2034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMYTHE",
"first_name": "ANDREW",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-08",
"last_updated": "2017-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "PG167651",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A15748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.