Kevin Matthew Smith, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G59269 Issued in CA

Practice address

715 Camino Catalina
Solana Beach, CA 92075-1631

Phone

(502) 235-6366

NPI assigned

Jun 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936

  Single Specialty

  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1023054004
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700314952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CAMINO CATALINA",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751631",
            "telephone_number": "502-235-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CAMINO CATALINA",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751631",
            "telephone_number": "502-235-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G59269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simplify Genomics Clinical Laboratory
• G. Preston Sims, PH.D.
• April Lynn Sisk, COTA
• Autumn Siverling
• Angela M Smith, DC
• David L Snyder, DIPL. O.M., C. HT.
• Sol Counseling and Wellness Studio, LLC
• Solana Beach Family Optometry
• Solana Beach Physical Therapy
• Solana Beach Physical Therapy Inc

• Pediatrics Physician in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.