Individual provider Active NPI

Kendal Smith, MD

  • Psychiatry Physician
  • Mesa, AZ
National Provider Identifier
1972000107
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
64770 Issued in AZ
Practice address
570 W Brown Rd
Mesa, AZ 85201-3227
Phone
(480) 344-2000
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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
Psychiatry Physician 2084P0800X 64770 AZ Primary

Addresses

Primary practice location

570 W Brown Rd
Mesa, AZ 85201-3227

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20221228002037 AZ Practitioner - Psychiatry 6204185846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arizona College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

570 W Brown Rd
Mesa, AZ 85201-3227
Phone (480) 344-2000

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64770AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Emergency Medicine CurrentSince Nov 14, 2022 Accepting new patients
District Medical Group, Inc CurrentSince Nov 14, 2022 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients

Locations

570 W Brown Rd
Mesa, AZ 85201
Phone (480) 344-2000

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

Interoperability endpoints

  • Direct secure messaging: ksmith78675@direct.valleywisehealth.org

Organizations & group practices 5

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1972000107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013227",
            "telephone_number": "480-344-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENDAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "64770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.