Active NPI
Brian Goff Smith, M.D.
- Family Medicine Physician
- Albuquerque, NM
National Provider Identifier
1881951366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- NM2015-074
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881951366 | Other | NM | NPI |
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
Enrollment records 1
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
Practice addresses (Care Compare)
85 W Hwy 22
Santo Domingo Pueblo, NM 87052-1283
Phone (505) 465-3060
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM2015-074 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kewa Pueblo Health Corporation | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Santo Domingo Pueblo, NM
- NPI 1467739888
TX
-
- Community/Behavioral Health Agency
- Santo Domingo Pueblo, NM
- NPI 1336659077
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.