Individual provider Active NPI

Dale B Smith, DO

  • Otolaryngology Physician
  • Lawton, OK
National Provider Identifier
1083660369
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2833 Issued in OK
Practice address
4920 SW Lee Blvd
Lawton, OK 73505-8339
Phone
(580) 536-8844
Fax
(580) 536-8818
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2833 OK Primary

Addresses

Primary practice location

4920 SW Lee Blvd
Lawton, OK 73505-8339

Mailing address

4920 SW Lee Blvd
Lawton, OK 73505-8339
Phone (580) 536-8844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20031113000685 OK Practitioner - Otolaryngology 6103730254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4920 SW Lee Blvd
Lawton, OK 73505-8339
Phone (580) 536-8844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Medical Anesthesia LLC Current Accepting new patients
Allergy Ear Nose and Throat Institute PLLC Otolaryngology CurrentSince Jun 1, 2006 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Surgery Center of Lawton Professional LLC PastSince Nov 14, 2011 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1015 E Broadway St
Ste 103
Altus, OK 73521

4920 SW Lee Blvd
Lawton, OK 73505
Phone (580) 536-8844

Organizations & group practices 5

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 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1083660369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058339",
            "telephone_number": "580-536-8844",
            "fax_number": "580-536-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058339",
            "telephone_number": "580-536-8844",
            "fax_number": "580-536-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DALE",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.