JORDAN SMITH CNM
NPI 1720700875
Advanced Practice Midwife in Berkeley, CA
About Jordan Smith Cnm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JORDAN SMITH CNM (NPI 1720700875) is an individual advanced practice midwife in Berkeley, California, licensed in California (236287) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jordan Smith Cnm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jordan Smith reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Berkeley, CA 94705
- Reassigned Medicare billing, California enrollment
- 132 clinicians in this Medicare group
Brooklyn, NY 11217
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Goncharov Medical PC
- 29 clinicians in this Medicare group
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 94705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
BERKELEY, CA 94705
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 Jordan Smith's NPI number?
The NPI number for Jordan Smith is 1720700875. It was assigned to this individual provider in the NPPES registry on September 15, 2022.
Where is Jordan Smith located?
Jordan Smith practices at 3101 Telegraph Ave, Berkeley, CA 94705. The listed phone number is (510) 280-5543.
What is Jordan Smith's specialty?
The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.
Is Jordan Smith enrolled in Medicare?
Yes. Jordan Smith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jordan Smith's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Smith reassigns Medicare benefits to 2 organizations: Sutter Bay Hospitals (Berkeley, CA) and Goncharov Medical, P.C. (Brooklyn, NY). Each 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 Jordan 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 Jordan Smith was last updated on October 30, 2022. 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.
# Jordan Smith, CNM · NPI 1720700875
Advanced Practice Midwife physician in Berkeley, California. Individual provider, active in the CMS NPPES registry since September 15, 2022.
## Identity
- **NPI:** 1720700875 (Entity type: Individual)
- **Enumerated:** September 15, 2022
- **Primary specialty:** Advanced Practice Midwife · taxonomy 367A00000X
- **State license:** 236287 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3101 TELEGRAPH AVE, Berkeley, CA 94705-1984
- **Phone:** (510) 280-5543
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Sutter Bay Hospitals (NPI 1639523004, Berkeley, CA); Goncharov Medical, P.C. (NPI 1831580091, Brooklyn, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** October 30, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1720700875) · Data from the CMS NPPES public registry.