Individual provider Active NPI

Leslie Jayne' Smith, FNP-C

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1730807884
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95022160 Issued in CA
Practice address
2018 W 80TH St
Los Angeles, CA 90047-2610
Phone
(323) 333-6448
NPI assigned
Aug 16, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95022160 CA Primary

Addresses

Primary practice location

2018 W 80TH St
Los Angeles, CA 90047-2610

Mailing address

2851 W 120TH St Ste E574
Hawthorne, CA 90250-3395
Phone (323) 333-6448

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827000165 CA Practitioner - Nurse Practitioner 6002355724 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Group of Montebello IncGroup PAC ID 2264715143, 55 clinicians
Im-FSR IncGroup PAC ID 6901035138, 28 clinicians

Practice addresses (Care Compare)

1701 Santa Anita Ave
S El Monte, CA 91733-3411
Phone (626) 579-7777

2701 S Bristol St
Santa Ana, CA 92704-6201
Phone (714) 754-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022160CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Im-FSR Inc. CurrentSince Jun 1, 2025 Accepting new patients
Hospitalist Group of Montebello Inc CurrentSince Jun 24, 2024 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1730807884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 W 120TH ST STE E574",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503395",
            "telephone_number": "323-333-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 W 80TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472610",
            "telephone_number": "323-333-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LESLIE",
        "middle_name": "JAYNE'",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.