Benjamin A Smith

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP61054509 Issued in WA

Practice address

100 Washington Ave S Ste 900
Minneapolis, MN 55401-2511

Phone

(866) 492-5336

NPI assigned

Mar 6, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NM, TX3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fedko Emergency Physicians New Mexico, LLCGroup PAC ID 4880934389, 53 clinicians

Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004
• Cibola General Hospital Hospital, Grants, NM, CCN 321308

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Fedko Emergency Physicians New Mexico LLC

  • Emergency Medicine Physician
  • Grants, NM
  • NPI 1770047441
  Medicare reassignment Care Compare group NPD
• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579
  Medicare reassignment Care Compare group NPD
• Cibola General Hospital Corporation

  • Critical Access Hospital
  • Grants, NM
  • NPI 1780677039
  Medicare reassignment NPD
• Comprehensive Postacute Care PLLC

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1023525698
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Fep West LLC

  • Emergency Medicine Physician
  • Gallup, NM
  • NPI 1023903499
  Medicare reassignment NPD
• Four Corners Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Alamogordo, NM
  • NPI 1144793464
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095

  NM

  Medicare reassignment NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756
  Medicare reassignment NPD
• Western Mountain Hospital Physicians PLLC

  • Hospitalist Physician
  • Alamogordo, NM
  • NPI 1992278360
  Medicare reassignment NPD
• Otero County Hospital Association

  • Community/Retail Pharmacy
  • Alamogordo, NM
  • NPI 1235948803
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789
  NPD

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

• Cibola General Hospital Corporation

  • Critical Access Hospital
  • Grants, NM
  • NPI 1780677039
  Care Compare affiliation
• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579
  Care Compare affiliation

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1205461522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 POINTE WOODWORTH DR NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984223480",
            "telephone_number": "253-517-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON AVE S STE 900",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012511",
            "telephone_number": "866-492-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60575277",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61054509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda J Smith, PA-C
• Amaya N Smith
• Andrew Charles Smith
• Angela Renee Smith, MD
• Anna M Smith, PAC
• Blair Marie Smith
• Bobbi Jo Smith, RN
• Brenda Mae Smith, LPN
• Carrie Susan Smith, NP
• Cecily Smith, MS, LPCC

• Gerontology Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.