Individual provider Active NPI

Brian Goff Smith, M.D.

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1881951366
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NM2015-074 Issued in NM
Practice address
MSC 09 5040
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone
(505) 272-6607
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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 NM2015-074 NM Primary

Addresses

Primary practice location

MSC 09 5040
1 University of New Mexico
Albuquerque, NM 87131-0001

Mailing address

1035 Alto St
Santa Fe, NM 87501-2406
Phone (505) 982-4425

Other identifiers 1

IdentifierTypeStateIssuer
1881951366OtherNMNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201106000580 TX Practitioner - Family Practice 0749414852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kewa Pueblo Health CorporationGroup PAC ID 7618137779, 29 clinicians

Practice addresses (Care Compare)

85 W Hwy 22
Santo Domingo Pueblo, NM 87052-1283
Phone (505) 465-3060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NM2015-074NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kewa Pueblo Health Corporation CurrentSince Nov 3, 2020 Accepting new patients
Kewa Pueblo Health Corporation Past Accepting new patients

Locations

85 W Highway 22
Santo Domingo Pueblo, NM 87052
Phone (505) 465-3060

Interoperability endpoints

  • Direct secure messaging: brian.smith.p1@direct.kp-hc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1881951366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 ALTO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875012406",
            "telephone_number": "505-982-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC 09 5040",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRIAN",
        "middle_name": "GOFF",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "NM2015-074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881951366",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.