JEAN E. SMITH MD
NPI 1154495455
Pediatrics in Santa Rosa, CA

Q: What is Jean Smith's NPI number?

The NPI number for Jean Smith is 1154495455. It was assigned to this individual provider in the NPPES registry on November 20, 2006.

Q: What is Jean Smith's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jean Smith was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 20, 2006PECOS Enrolled

401 BICENTENNIAL WAY, SANTA ROSA, CA 95403(707) 571-4000 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 10, 2021, Feb 4, 2021 (2 updates tracked since 2021).

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About Jean E. Smith Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAN E. SMITH MD (NPI 1154495455) is an individual pediatrics provider in Santa Rosa, California, licensed in California (G26460) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154495455

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJEAN E. SMITHCredential: MD

Location Address401 BICENTENNIAL WAYSanta Rosa, CA 95403-2149

Mailing Address1800 Harrison St Fl 7Oakland, CA 94612-3429 · (510) 625-6262

Phone(707) 571-4000

Sole ProprietorNo

Enumeration DateNovember 20, 2006

Last NPPES UpdateNovember 10, 20212 updates tracked since enumeration

NPPES CertifiedNovember 10, 2021

✔ NPI 1154495455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · G26460

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

401 BICENTENNIAL WAY, Santa Rosa, CA 95403

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Other Identifiers 1

Medicaid00G264600CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean E. Smith Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jean Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Medical Foundation

2.5 mi

Internal Medicine

500 DOYLE PARK DR, SUITE 303
Santa Rosa, CA 95405

Reassigned Medicare billing, California enrollment
1,699 clinicians in this Medicare group

NPI 1740584473 (707) 303-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JESSICA ANNE RUTLAND R.D.

Dietitian, Registered

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 393-4787

KURT FALKENBERG P.T.

Physical Therapist

401 BICENTENNIAL WAY, EAST BUILDING, SUITE 190
SANTA ROSA, CA 95403

Sonoma County (707) 571-3352

DELILAH PATTERSON CRNA

Nurse Anesthetist, Certified Registered

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 393-4616

KRISZTINA J. BALAZS MD

Pediatrics

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 571-4000

JOHN F. KUNKEL MD

Pathology (Anatomic Pathology)

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 571-4000

CRISTINA COREY SCHROEN LCSW

Social Worker (Clinical)

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 571-2536

JIE GIOK RAHARDJA PHARMD

Pharmacist

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (707) 393-4652

CONOR WILLIAM BOWMAN PHARM.D.

Pharmacist

401 BICENTENNIAL WAY
SANTA ROSA, CA 95403

Sonoma County (818) 522-1238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jean Smith's NPI number?

The NPI number for Jean Smith is 1154495455. It was assigned to this individual provider in the NPPES registry on November 20, 2006.

Where is Jean Smith located?

Jean Smith practices at 401 Bicentennial Way, Santa Rosa, CA 95403. The listed phone number is (707) 571-4000.

What is Jean Smith's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jean Smith enrolled in Medicare?

Yes. Jean Smith is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jean Smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jean Smith reassigns Medicare benefits to Providence Medical Foundation (Santa Rosa, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jean Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jean Smith was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.