Individual provider Active NPI

Mark W Smith, MD

  • Hospitalist Physician
  • Seattle, WA
National Provider Identifier
1104914761
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD00045081 Issued in WA
Practice address
1145 Broadway
Seattle, WA 98122-4201
Phone
(206) 329-1760
NPI assigned
Oct 10, 2006
Last updated
May 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00045081 WA
Hospitalist Physician 208M00000X MD00045081 WA Primary

Addresses

Primary practice location

1145 Broadway
Seattle, WA 98122-4201

Mailing address

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

Other identifiers 5

IdentifierTypeStateIssuer
US7684713OtherWAAETNA SPECIALIST PIN
A8430746MedicaidWA
0039581OtherWALABOR AND INDUSTRIES #
0138SMOtherWABLUE SHIELD #
1002568MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20050726000437 WA Practitioner - HospitalistPractitioner - Internal Medicine 3678500279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Howard University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Internal Medicine CurrentSince Jun 9, 2022 Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Jan 20, 2015 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Oct 28, 2010 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Oct 28, 2010 Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Jan 20, 2015 Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

1145 Broadway
Seattle, WA 98122

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

Organizations & group practices 5

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 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1104914761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-329-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00045081",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD00045081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US7684713",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A8430746",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039581",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "0138SM",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002568",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.