Individual provider Active NPI

Emily Kathryn Diconza Smith, PA

  • Physician Assistant
  • Gardner, MA
National Provider Identifier
1003232612
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1552 Issued in NH
Practice address
59 Eastwood Cir
Gardner, MA 01440-3901
Phone
(872) 231-3162
Fax
(702) 977-1496
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 1552 NH Primary
Physician Assistant 363A00000X PA4953 MA

Addresses

Primary practice location

59 Eastwood Cir
Gardner, MA 01440-3901

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150204000146 MA Practitioner - Physician Assistant 9739404229 Reassigns benefits to 5 organizations
I20200324002714 NH Practitioner - Physician Assistant 9739404229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph Hospital of Nashua NHGroup PAC ID 2062455611, 271 clinicians

Practice addresses (Care Compare)

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 884-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1552NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital Physician Assistant CurrentSince Sep 1, 2018 Accepting new patients
Athol Memorial Hospital Incorporated Physician Assistant CurrentSince Jul 1, 2019 Accepting new patients
Integrated Rehab Consultants LLC CurrentSince Mar 1, 2025 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Mar 23, 2020 Accepting new patients
Heywood Affiliated Medical Group Inc. CurrentSince Mar 2, 2015 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

59 Eastwood Cir
Gardner, MA 01440
Phone (978) 632-5048

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

476 Varnum Ave
Lowell, MA 01854
Phone (978) 458-3388

204 Proctor Ave
Revere, MA 02151
Phone (781) 286-3100

40 Julio Dr
Shrewsbury, MA 01545
Phone (508) 841-4755

101 Plantation St
Worcester, MA 01604
Phone (501) 604-3025

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

168 Kinsley St
Nashua, NH 03060
Phone (603) 578-9363

Interoperability endpoints

  • Direct secure messaging: esmith1155880@direct.bsmhealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1003232612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008272",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748272",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EASTWOOD CIR",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403901",
            "telephone_number": "872-231-3162",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EMILY",
        "middle_name": "KATHRYN DICONZA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1552",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.