Individual provider Active NPI

Jeffrey A Smith, M.D.

  • Gastroenterology Physician
  • Southlake, TX
National Provider Identifier
1134105083
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
L1464 Issued in TX
Practice address
505 S Nolen Dr
Southlake, TX 76092-9167
Phone
(817) 424-1525
Fax
(817) 424-3491
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X L1464 TX Primary

Addresses

Primary practice location

505 S Nolen Dr
Southlake, TX 76092-9167

Mailing address

PO Box 35629
Dallas, TX 75235-0629
Phone (214) 424-2213

Other identifiers 1

IdentifierTypeStateIssuer
8004K1OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100430000628 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 1759394919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Texas Medical Branch at Galveston, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2665 Scripture St
Suite 210
Denton, TX 76201-2302
Phone (940) 222-6900

505 S Nolen Dr
A
Southlake, TX 76092-9167
Phone (817) 424-1525

5425 W Spring Creek Pkwy
Suite 205
Plano, TX 75024-4236
Phone (972) 526-5860

601 S Main St
Keller, TX 76248-7029
Phone (817) 741-4347

9509 N Beach St
Fort Worth, TX 76244-6399
Phone (817) 741-4347

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy101
Upper gastrointestinal (GI) endoscopy for acid reflux128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1464TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Jul 2, 2001 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jul 2, 2001 Accepting new patients

Locations

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

505 S Nolen Dr
Ste A
Southlake, TX 76092
Phone (817) 424-1525

505 S Nolen Dr
Southlake, TX 76092
Phone (817) 424-1525

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.

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1134105083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35629",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2213",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S NOLEN DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-424-1525",
            "fax_number": "817-424-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L1464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8004K1",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.