Individual provider Active NPI

Megan Smith, PA-C

  • Medical Physician Assistant
  • Coos Bay, OR
National Provider Identifier
1093263386
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA190162 Issued in OR
Practice address
375 Park Ave Ste 5
Coos Bay, OR 97420
Phone
(541) 267-7543
Fax
(503) 362-8435
NPI assigned
Sep 14, 2016
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA190162 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

375 Park Ave Ste 5
Coos Bay, OR 97420

Mailing address

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Other practice location 1

2730 SW Moody Ave
Cl5Pa
Portland, OR 97201-5042
Phone (503) 494-3633

Other practice location 2

1793 13th St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Other identifiers 1

IdentifierTypeStateIssuer
500757502MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190322000250 OR Practitioner - Physician Assistant 7012257447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul D. Reicherter, MD, PCGroup PAC ID 4082687298, 13 clinicians

Practice addresses (Care Compare)

1813 W Harvard Ave
Suite 310
Roseburg, OR 97471-2756
Phone (541) 672-7546

385 Ranch Rd
Reedsport, OR 97467-1707
Phone (844) 209-4499

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
76.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA190162ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC CurrentSince Dec 22, 2018 Accepting new patients

Locations

1390 Waverly Dr SE
Albany, OR 97322
Phone (541) 967-8385

375 Park Ave
Ste 5
Coos Bay, OR 97420
Phone (541) 267-7543

3132 State St
Ste 110
Medford, OR 97504
Phone (541) 732-1686

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

Interoperability endpoints

  • Direct secure messaging: msmith@advskinctr.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1093263386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 PARK AVE STE 5",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "97420",
            "telephone_number": "541-267-7543",
            "fax_number": "503-362-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 SW Moody Ave",
            "address_2": "CL5PA",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972015042",
            "country_code": "US",
            "telephone_number": "503-494-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1793 13th St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973022541",
            "country_code": "US",
            "telephone_number": "503-362-8385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MEGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA190162",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500757502",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.