NPIMap

Individual provider Active NPI

Benjamin T Smith, DO

  • Orthopaedic Surgery of the Spine Physician
  • Moreno Valley, CA
National Provider Identifier
1881905438
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
49886 Issued in MT
Practice address
26520 Cactus Ave
C/O Gme Office RM. A1005
Moreno Valley, CA 92555-3927
Phone
(951) 486-5908
Fax
(951) 486-5910
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery of the Spine Physician 207XS0117X 49886 MT Primary

Addresses

Primary practice location

26520 Cactus Ave
C/O Gme Office RM. A1005
Moreno Valley, CA 92555-3927

Mailing address

26520 Cactus Ave
C/O Gme Office RM. A1005
Moreno Valley, CA 92555-3927
Phone (951) 486-5908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817002739 MT Practitioner - Orthopedic Surgery 4486886850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Kansas City University of Physicians and Surgeons, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridger Orthopedics and Sports Medicine PCGroup PAC ID 4587627096, 69 clinicians

Practice addresses (Care Compare)

1450 Ellis St
Suite 201
Bozeman, MT 59715-8813
Phone (406) 587-0122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
60.05
Promoting interoperability
100
Improvement activities
40
Cost
76.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion297
Laminectomy or laminotomy (partial removal of spine bones)54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49886MTMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridger Orthopedics and Sports Medicine, PC Orthopaedic Surgery of the Spine CurrentSince Sep 16, 2016 Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients

Locations

1450 Ellis St
Ste 201
Bozeman, MT 59715
Phone (406) 522-1144

Interoperability endpoints

  • Direct secure messaging: benjamin.smith.1@12906.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12906/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1881905438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "C/O GME OFFICE RM. A1005",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5908",
            "fax_number": "951-486-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "C/O GME OFFICE RM. A1005",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5908",
            "fax_number": "951-486-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MT",
            "license": "49886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.