Individual provider Active NPI

Susan Smith

  • Family Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1811900897
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G38605 Issued in CA
Practice address
795 El Camino Real
Palo Alto, CA 94301-2302
Phone
(650) 321-4121
NPI assigned
Aug 14, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G38605 CA Primary

Addresses

Primary practice location

795 El Camino Real
Palo Alto, CA 94301-2302

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201

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
I20080820000316 CA Practitioner - Family Practice 1254412497 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38605CAMDDentist
G38605CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Oct 8, 2023 Accepting new patients
University of California San Francisco Current Accepting new patients

Locations

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1811900897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012302",
            "telephone_number": "650-321-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G38605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.