Active NPI
Michael Joseph Smith, PSY.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1740201235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY20563
- Practice address
- 1304 Castro St
Suite B
San Francisco, CA 94114-3683 - Phone
- (415) 310-8873
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY20563 | CA | Primary |
Addresses
Primary practice location
1304 Castro St
Suite B
San Francisco, CA 94114-3683
Mailing address
321 Roosevelt Way
#3
San Francisco, CA 94114-1433
Phone (415) 310-8873
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPL20563 | Other | CA | BLUE SHIELD OF CA |
| PSY20563 | Other | CA | MEDI-CAL |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060509001027 | CA | Practitioner - Clinical Psychologist | 8022029750 | Practice locations: San Francisco, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1304 Castro St
Suite B
San Francisco, CA 94114-3682
Phone (415) 310-8873
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1740201235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 ROOSEVELT WAY",
"address_2": "#3",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141433",
"telephone_number": "415-310-8873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 CASTRO ST",
"address_2": "SUITE B",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941143683",
"telephone_number": "415-310-8873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20563",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "OPL20563",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "PSY20563",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.