Kelly Smith, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

49780 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Phone

(480) 301-8000

NPI assigned

Nov 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Tung Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Diagnostic Radiology

Education

Ohio State University College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Valley Community Medical ImagingGroup PAC ID 5799679874, 97 clinicians

California Imaging Institute Medical Group IncGroup PAC ID 1951325299, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
• Adventist Health Hanford Hospital, Hanford, CA, CCN 050121
• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Adventist Health Reedley Hospital, Reedley, CA, CCN 050192

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• California Imaging Institute Medical Group Inc

  • Radiology Clinic/Center
  • Fresno, CA
  • NPI 1497764468
  Medicare reassignment Care Compare group NPD
• Central Valley Community Medical Imaging

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1376637264
  Medicare reassignment Care Compare group NPD
• Einstein Practice Plan Inc

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1396703955
  NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation
• Hanford Community Hospital

  • General Acute Care Hospital
  • Hanford, CA
  • NPI 1538141627
  Care Compare affiliation
• Reedley Community Hospital

  • General Acute Care Hospital
  • Reedley, CA
  • NPI 1336167550
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1144201799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A97602",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "49780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "TUNG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan H Smith, M.D.
• Julianna Marie Smith, MD, MS
• Kaitlin S Smith, CPNP
• Karen Louise Smith, DPM
• Kathleen Grady Smith, P.T, NCS
• Kimberly Kay Smith, RN
• Kody Je Smith, M.D.
• Kyle Smith, PHARM D.
• Lindsey Lee Smith, RN
• Lindsey Sheree Smith

• Diagnostic Radiology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.