Individual provider Active NPI

Michael G Smith, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1013383892
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1218 South Broadway
Ste 310
Lexington, KY 40504-2759
Phone
(859) 219-0542
Fax
(859) 219-9433
NPI assigned
Aug 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1218 South Broadway
Ste 310
Lexington, KY 40504-2759

Mailing address

1218 South Broadway
Ste 310
Lexington, KY 40504-2759
Phone (859) 219-0542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151027001976 KY Practitioner - Physician Assistant 2769791094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians

Practice addresses (Care Compare)

1140 Lexington Rd
Georgetown, KY 40324-9330
Phone (615) 312-0600

175 Hospital Dr
Winchester, KY 40391-9591
Phone (615) 312-0600

1801 Ashley Cir
Bowling Green, KY 42104-3362
Phone (615) 312-0600

801 Eastern Byp
Richmond, KY 40475-2751
Phone (615) 312-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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 1

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1013383892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 SOUTH BROADWAY",
            "address_2": "STE 310",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042759",
            "telephone_number": "859-219-0542",
            "fax_number": "859-219-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 SOUTH BROADWAY",
            "address_2": "STE 310",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042759",
            "telephone_number": "859-219-0542",
            "fax_number": "859-219-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.