Philip Sheridan Smith, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

144650 Issued in NY

Practice address

164 Willow Ave
Cornwall, NY 12518-1329

Phone

(845) 534-8271

Fax

(845) 534-8145

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1003815440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WILLOW AVE",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181329",
            "telephone_number": "845-534-8271",
            "fax_number": "845-534-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WILLOW AVE",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181329",
            "telephone_number": "845-534-8271",
            "fax_number": "845-534-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHILIP",
        "middle_name": "SHERIDAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "144650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "75D541",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00966629",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Irving Schreiner, M.D.
• Eric Scott
• Seema Das Physical Therapy PLLC
• Gay Smerek, RPH
• Gina Maria Smith, RN
• St Luke'S Cornwall Hospital
• St Luke'S Cornwall Hospital
• St. Luke'S Cornwall JV, LLC
• Stefanie Vidal Acupuncture PLLC
• Thomas Patrick Stein, DDS

• Infectious Disease Physician in Cornwall, NY
• Providers in Cornwall, NY by specialty
• Infectious Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.