NPIMap

Individual provider Active NPI

Joseph Smith II, PA-C

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1134580079
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
123456 Issued in AZ
Practice address
654 E 84TH St
Chicago, IL 60619-5802
Phone
(312) 927-1276
NPI assigned
Mar 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 123456 AZ Primary
Physician Assistant 363A00000X 6345 AZ

Addresses

Primary practice location

654 E 84TH St
Chicago, IL 60619-5802

Mailing address

654 E 84TH St
Chicago, IL 60619-5802
Phone (312) 927-1276

Other practice location 1

520 Rose Ln
Wickenburg, AZ 85390-1447
Phone (928) 668-1803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160511002686 AZ Practitioner - Physician Assistant 9436448685 Reassigns benefits to 10 organizations
I20211202000172 TX Practitioner - Physician Assistant 9436448685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truecare Urgent Care LLCGroup PAC ID 3173951514, 10 clinicians

Practice addresses (Care Compare)

2035 Mesquite Ave
Suite a
Lake Havasu City, AZ 86403-5894
Phone (928) 846-4343

Hospital & facility affiliations

  • Exceptional Community Hospital Bullhead City Hospital, Bullhead City, AZ, CCN 030155
  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6345AZMDDentist
123456AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Arizona Inc CurrentSince Oct 28, 2017 Accepting new patients
Gila River Health Care CurrentSince Nov 25, 2021 Accepting new patients
Gila River Health Care Corporation CurrentSince Nov 25, 2021 Accepting new patients
Exceptional Health Care Prescott LLC PastSince Aug 1, 2024 Accepting new patients
Burt Faibisoff, MD, PLLC Past Accepting new patients
Exceptional Health Care Bullhead City LLC PastSince Nov 19, 2023 Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

7300 State Highway 121
Ste 374
McKinney, TX 75070

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 2

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1134580079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E 84TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195802",
            "telephone_number": "312-927-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E 84TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195802",
            "telephone_number": "312-927-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Rose Ln",
            "address_purpose": "LOCATION",
            "city": "Wickenburg",
            "state": "AZ",
            "postal_code": "853901447",
            "country_code": "US",
            "telephone_number": "928-668-1803",
            "fax_number": "928-684-2434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOSEPH",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "123456",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.