Penelope Juvrud Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41726 Issued in MN

Practice address

14701 Victor Hugo Blvd N
Hugo, MN 55038-4561

Phone

(952) 853-8800

NPI assigned

Dec 7, 2005

Last updated

Jan 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: psmith32424@direct.centracare.com

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.

• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Unity Family Healthcare

  dba Little Falls Orthopedics

  • Orthopaedic Surgery Physician
  • Little Falls, MN
  • NPI 1326234006
  Medicare reassignment NPD
• Unity Family Healthcare

  dba St. Gabriel's Hospital

  • Critical Access Hospital
  • Little Falls, MN
  • NPI 1780630939
  Medicare reassignment NPD
• Centracare Clinic

  dba CentraCare Occupations Health

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Unity Family Healthcare

  dba CHI Health at Home

  • Home Health Agency
  • Little Falls, MN
  • NPI 1952329047
  NPD
• Unity Family Healthcare

  dba Community Medical Center

  • Family Medicine Physician
  • Pierz, MN
  • NPI 1952530669
  NPD
• Centracare Clinic

  dba CentraCare - St. Joseph Clinic

  • Multi-Specialty Clinic/Center
  • Saint Joseph, MN
  • NPI 1134121759
  NPD (past)
• Centracare Clinic

  dba CentraCare - Plaza Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1124003751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 VICTOR HUGO BLVD N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550384561",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PENELOPE",
        "middle_name": "JUVRUD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024217900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080149404",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Shannon
• Lindsey Ann Shiltz
• Alicia Marie Skupa, PA-C
• Abigail Murphy Smith
• Anja Smith, DPT
• Sorenson Dental
• Brent Sorenson, D.D.S.
• Nicholas H Sorenson, PA-C
• St. Croix Valley Dental (Oneka Dental)
• Marah Steele

• Family Medicine Physician in Hugo, MN
• Providers in Hugo, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.