Kent W Small, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A53173 Issued in CA

Practice address

411 N Central Ave Ste 115
Glendale, CA 91203-3138

Phone

(818) 552-5040

Fax

(818) 552-5044

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Tulane University School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carson McBeath and Boswell IncGroup PAC ID 1153325394, 7 clinicians

Kent W Small MD a Medical CorporationGroup PAC ID 8325001415, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kentsmallmd@macularetinainstitute.direct.eyemdemr.com

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.

• Kent W Small, MD a Medical Corporation

  • Ophthalmology Physician
  • Glendale, CA
  • NPI 1699947796

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Carson McBeath & Boswell Inc.

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1710970728

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jules Stein Eye Institute Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Fountain Valley, CA
  • NPI 1770938292
  NPD (past)
• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1861470783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 NORTH ORANGE STREET",
            "address_2": "SUITE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031971",
            "telephone_number": "818-552-5040",
            "fax_number": "818-552-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE STE 115",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033138",
            "telephone_number": "818-552-5040",
            "fax_number": "818-552-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "KENT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A53173",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A53173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75843Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Skylight Hospice Inc
• Skyteam Hospice, Inc
• Brandon Slavin, CMT
• Sleep Disorders Center
• MK Sloan, PTA
• Smart Steps ABA
• Smile Dental Practice
• Smile to Life
• Smith Family Chiropractic
• Joe A. Smith, DC

• Ophthalmology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.

Verify at the official NPI Registry.