Individual provider Active NPI

Mark A. Smith, M.D.

  • Vascular Surgery Physician
  • Orange, CA
National Provider Identifier
1710088752
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G47011 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8000
Fax
(855) 211-3729
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 00G470110 CA
Vascular Surgery Physician 2086S0129X G47011 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

1100 N Palm Canyon Dr
Suite 211
Palm Springs, CA 92262-4414
Phone (760) 320-9019

Other practice location 1

1100 N Palm Canyon Dr
Suite 211
Palm Springs, CA 92262-4414
Phone (760) 320-9019

Other identifiers 1

IdentifierTypeStateIssuer
G470110MedicaidCA

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
I20081125000286 CA Practitioner - General SurgeryPractitioner - Vascular Surgery 1557421286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgeons of Orange a Medical GroupGroup PAC ID 6901705227, 116 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 634-5549

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00G470110CAMDSpecialist
G47011CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgeons of Orange a Medical Group Vascular Surgery CurrentSince Mar 15, 2008 Accepting new patients
Mark Allan Smith, M.D., PC CurrentSince Oct 1, 2024 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

23961 Calle de la Magdalena
Ste 4
Laguna Hills, CA 92653

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1710088752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 211",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-320-9019",
            "fax_number": "760-320-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8000",
            "fax_number": "855-211-3729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N Palm Canyon Dr",
            "address_2": "SUITE 211",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624414",
            "country_code": "US",
            "telephone_number": "760-320-9019",
            "fax_number": "760-320-9685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "00G470110",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G47011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G470110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.