Blake Andre Smith, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

50.004031 Issued in OH

Practice address

2854 Bell St
Zanesville, OH 43701-1721

Phone

(740) 454-3273

Fax

(740) 588-1081

NPI assigned

Mar 20, 2014

Last updated

Aug 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Home Care Home health agency, Zanesville, OH, CCN 367114
• Genesis Hospital Hospital, Zanesville, OH, CCN 360039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
  • NPI 1063663433
  Medicare reassignment Care Compare group NPD
• Genesis Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Coshocton, OH
  • NPI 1144022187
  NPD
• Genesis Primary Care Physicians LLC

  • Family Medicine Physician
  • Zanesville, OH
  • NPI 1790061513
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Healthcare System

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1184435414

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  dba Genesis Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1477150951

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  • General Acute Care Hospital
  • Zanesville, OH
  • NPI 1598868655
  Care Compare affiliation
• Genesis Healthcare System

  dba Genesis Outpatient Pharmacy 1C

  • Community/Retail Pharmacy
  • Coshocton, OH
  • NPI 1710839436

  Hospital

  Care Compare affiliation
• Zanesville Homecare Ventures, LLC

  • Home Health Agency
  • Zanesville, OH
  • NPI 1568772721
  Care Compare affiliation

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1093132631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 BELL ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011721",
            "telephone_number": "740-454-3273",
            "fax_number": "740-588-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 BELL ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011721",
            "telephone_number": "740-454-3273",
            "fax_number": "740-588-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BLAKE",
        "middle_name": "ANDRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.004031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101439",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Sklenar Williams
• Tiffany M Smeltzer, LPN
• Smiles on the Go
• Sarah Louise Smiley, CNP
• Amanda L Smith, CRNA
• Bobbie M. Smith, CRNP
• Caitlyn Smith, APRN
• Chelsie Lousie Smith
• Cole David Smith, PHARMD, RPH
• Debra R Smith

• Surgical Physician Assistant in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.