NPIMap

Individual provider Active NPI

Ralph Henry Smith Jr., PA

  • Physician Assistant
  • Teec Nos Pos, AZ
National Provider Identifier
1003157660
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
98-PA20 Issued in NM
Practice address
US Hwy 160 & Navajo Route 35- Red Mesa
Teecnospos, AZ 86514
Phone
(928) 656-5000
NPI assigned
Mar 7, 2013
Last updated
Aug 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5431 GA
Physician Assistant 363A00000X 98-PA20 NM Primary

Addresses

Primary practice location

US Hwy 160 & Navajo Route 35- Red Mesa
Teecnospos, AZ 86514

Mailing address

HC 61 Box 30
Teec Nos Pos, AZ 86514-9600
Phone (928) 656-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ralph.Smith@SRSU.directihs.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161205001968 TX Practitioner - Physician Assistant 3577843770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

US Hwy 160 and Navajo Route 35-Red Mesa
Teecnospos, AZ 86514
Phone (928) 656-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5431GAMDPhysician Assistant
98-PA20NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 2, 2016 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 2, 2016 Accepting new patients
DHHS PHS Naihs Shiprock Hospital PastSince Aug 15, 2021 Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Interoperability endpoints

  • Direct secure messaging: ralph.smith@srsu.directihs.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1003157660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 61 BOX 30",
            "city": "TEEC NOS POS",
            "state": "AZ",
            "postal_code": "865149600",
            "telephone_number": "928-656-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 160 & NAVAJO ROUTE 35- RED MESA",
            "city": "TEECNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RALPH",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2021-08-10",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5431",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "98-PA20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ralph.Smith@SRSU.directihs.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "US Hwy 160 & Navajo Route 35- Red Mesa",
            "city": "Teecnospos",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Teec Nos Pos, AZ

Sources for this page

Verify at the official NPI Registry.