Individual provider Active NPI

Susan Mae Smith, M.D.

  • Obstetrics & Gynecology Physician
  • Tampa, FL
National Provider Identifier
1093920969
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME98456 Issued in FL
Practice address
12901 Bruce B Downs Blvd
MDC 33
Tampa, FL 33612-4742
Phone
(813) 259-8500
NPI assigned
May 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME98456 FL Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd
MDC 33
Tampa, FL 33612-4742

Mailing address

PO Box 917770
Orlando, FL 32891-7770

Other identifiers 1

IdentifierTypeStateIssuer
90618OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070924000423 FL Practitioner - Obstetrics/Gynecology 4981798717 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Obstetrics & Gynecology CurrentSince Mar 10, 2023 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Sep 3, 2022 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Sep 3, 2022 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Winter Haven Hospital Inc Obstetrics & Gynecology PastSince Nov 24, 2019 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

101 Avenue O SE
Winter Haven, FL 33880
Phone (863) 294-7010

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1093920969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "address_2": "MDC 33",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-259-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME98456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "90618",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.