Individual provider Active NPI

Donald Brock Smith, DO

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1093336943
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
02008949A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(317) 962-6793
NPI assigned
May 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7387 OK
Vascular & Interventional Radiology Physician 2085R0204X 81799-21 WI
Vascular & Interventional Radiology Physician 2085R0204X 02008949A IN
Diagnostic Radiology Physician 2085R0202X 02008949A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

8701 Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-4575

Other practice location 2

3300 NW Expressway
Oklahoma City, OK 73112-4999
Phone (405) 949-3284

Other identifiers 1

IdentifierTypeStateIssuer
300131719MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DSMITH@DIRECT.IUHEALTH.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241108002630 OK Practitioner - Diagnostic Radiology 8820411267 Reassigns benefits to 2 organizations
I20260528001430 IN Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8820411267

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Marian University College of Osteopathic Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7387OKMDDiagnostic Radiology Physician
81799-21WIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Hospital Authority Southwest Radiology Diagnostic Radiology CurrentSince Sep 17, 2024 Accepting new patients
Oklahoma Radiology Group P C Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1093336943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-6793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-4575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 NW Expressway",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124999",
            "country_code": "US",
            "telephone_number": "405-949-3284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DONALD",
        "middle_name": "BROCK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-01",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "7387",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "81799-21",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "02008949A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "02008949A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300131719",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DSMITH@DIRECT.IUHEALTH.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.