NPIMap

Organization Active NPI

Smart Health & Wellness

  • Orthopaedic Surgery Physician
  • Aliso Viejo, CA
National Provider Identifier
1679227326
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SMART HEALTH & WELLNESS
Practice address
27372 Aliso Creek Rd Ste 200
Aliso Viejo, CA 92656-5339
Phone
(949) 520-1012
Fax
(949) 520-1045
NPI assigned
Feb 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Raymond Benjamin Raven
Title
Ceo & Partner
Phone
(818) 579-2362

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X

Addresses

Primary practice location

27372 Aliso Creek Rd Ste 200
Aliso Viejo, CA 92656-5339

Mailing address

27372 Aliso Creek Rd Ste 200
Aliso Viejo, CA 92656-5339
Phone (818) 579-2362

Other practice location 1

27372 Aliso Creek Rd Ste 110
Aliso Viejo, CA 92656-5339
Phone (949) 520-1014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230810004181 CA Part B Supplier - Clinic/Group Practice 0749642585 Receives reassigned benefits from 9 practitioners
Practice locations: Aliso Viejo, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

27372 Aliso Creek Rd
Ste 201
Aliso Viejo, CA 92656

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1679227326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27372 ALISO CREEK RD STE 200",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565339",
            "telephone_number": "818-579-2362",
            "fax_number": "818-579-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27372 ALISO CREEK RD STE 200",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565339",
            "telephone_number": "949-520-1012",
            "fax_number": "949-520-1045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27372 Aliso Creek Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Aliso Viejo",
            "state": "CA",
            "postal_code": "926565339",
            "country_code": "US",
            "telephone_number": "949-520-1014",
            "fax_number": "949-791-4595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SMART HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "RAVEN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "CEO & PARTNER",
        "authorized_official_telephone_number": "818-579-2362"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.