Individual provider Active NPI

Jon B Smucker, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Elkhart, IN
National Provider Identifier
1093918476
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
01067873A Issued in IN
Practice address
2310 California Rd Ste a
Elkhart, IN 46514-1228
Phone
(574) 264-0791
Fax
(574) 262-5183
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 10167873A IN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 01067873A IN Primary

Addresses

Primary practice location

2310 California Rd Ste a
Elkhart, IN 46514-1228

Mailing address

2310 California Rd Ste a
Elkhart, IN 46514-1228
Phone (574) 264-0791

Other identifiers 1

IdentifierTypeStateIssuer
200981040MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100826000454 IN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 0840325171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2310 California Rd
Elkhart, IN 46514-1228
Phone (574) 264-0791

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.85 of 100Reported as group
Quality
59.71
Promoting interoperability
90
Improvement activities
40
Cost
88.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement19
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10167873AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ASC Surgical Ventures, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ben.smucker@direct.osmc.nextgenshare.com
  • Direct secure messaging: jon.smucker.1@18573.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1093918476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-264-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-264-0791",
            "fax_number": "574-262-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUCKER",
        "first_name": "JON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "10167873A",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "01067873A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200981040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.