Individual provider Active NPI

Jeffrey Ryan Smit, M.D.

  • Otolaryngology Physician
  • Clive, IA
National Provider Identifier
1083874853
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
38808 Issued in IA
Practice address
1601 NW 114TH St
Ste: 230
Clive, IA 50325-7007
Phone
(515) 222-7761
Fax
(515) 222-7926
NPI assigned
Jun 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MT186055 PA
Otolaryngology Physician 207Y00000X 38808 IA Primary

Addresses

Primary practice location

1601 NW 114TH St
Ste: 230
Clive, IA 50325-7007

Mailing address

PO Box 4925
Des Moines, IA 50305-4925
Phone (515) 222-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100921000761 IA Practitioner - Otolaryngology 8426173980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

1601 NW 114TH St
230 Mercyone Clive ENT Care Clinic
Clive, IA 50325-7035
Phone (515) 222-7761

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 247-4240

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38808IAMDOtolaryngology Physician
MT186055PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics Inc CurrentSince Aug 1, 2010 Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 1, 2010 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

1601 NW 114th St
Ste 240
Des Moines, IA 50325
Phone (515) 222-7700

1601 NW 114th St
Ste 230
Des Moines, IA 50325
Phone (515) 222-7728

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

Interoperability endpoints

  • Direct secure messaging: jsmit3958074@direct.trinity-health.org
  • Direct secure messaging: jsmit12577@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1083874853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4925",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503054925",
            "telephone_number": "515-222-7761",
            "fax_number": "515-222-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST",
            "address_2": "STE: 230",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257007",
            "telephone_number": "515-222-7761",
            "fax_number": "515-222-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIT",
        "first_name": "JEFFREY",
        "middle_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-14",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT186055",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "38808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.