Jeffrey R Smolin, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1234 Issued in AZ

Practice address

2034 S Alma School Rd Ste 2
Mesa, AZ 85210-4004

Phone

(480) 831-0150

Fax

(480) 831-0240

NPI assigned

Jan 6, 2009

Last updated

Jan 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1194961540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 S ALMA SCHOOL RD STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104004",
            "telephone_number": "480-831-0150",
            "fax_number": "480-831-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 S ALMA SCHOOL RD STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104004",
            "telephone_number": "480-831-0150",
            "fax_number": "480-831-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLIN",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Smiths Food & Drug Centers Inc (FRYS FOOD AND DRUG Store #611)
• Jeanette Marie Smithson, RNP
• Robert P Smithson, DDS
• Iva A Smolens, MD
• Anita Smullin, LCPC
• Dawn Smyth
• Cindy Rae Sneller, DNP, RN, CNS
• Suzanne Carol Snodderly, RN
• Snow Family Smiles LLC (Snow Family Dentistry)

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.