Active NPI
Josiah Smith, PA-C
- Physician Assistant
- Caldwell, ID
National Provider Identifier
1235100991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-2166
- Practice address
- 512 E Elm St
Caldwell, ID 83605-4871 - Phone
- (208) 370-7004
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-2166 | ID | |
| Medical Physician Assistant | 363AM0700X | PA939 | NV | |
| Physician Assistant | 363A00000X | PA-2166 | ID | Primary |
Addresses
Primary practice location
512 E Elm St
Caldwell, ID 83605-4871
Mailing address
512 E Elm St
Caldwell, ID 83605-4871
Phone (208) 370-7004
Other practice location 1
2825 Siena Heights Dr
Henderson, NV 89052
Phone (702) 617-1227
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235100991 | Medicaid | NV | |
| 100507371 | Medicaid | NV | |
| 100508544 | Other | NV | MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, ID, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16111 N Brinson St
Suite 110
Nampa, ID 83687-5509
Phone (208) 468-9400
4850 N Rosepoint Way
Suite 100
Boise, ID 83713-5262
Phone (208) 939-2100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-2166 | ID | MD | Physician Assistant |
| PA939 | NV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medical Associates, PLLC | Physician Assistant | Past | Accepting new patients |
| Gary Gregerson MD PA | Past | Accepting new patients |
Organizations & group practices 9
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.
-
dba Advanced Specialty Care For Women
- Obstetrics & Gynecology Physician
- Nampa, ID
- NPI 1255762506
-
dba Southwest Medical
- Internal Medicine Physician
- Las Vegas, NV
- NPI 1790329407
-
- Internal Medicine Physician
- Las Vegas, NV
- NPI 1659346005
-
dba Advanced Specialty Care for Women
- Obstetrics & Gynecology Physician
- Nampa, ID
- NPI 1902179914
-
- Emergency Medicine Physician
- Lansing, MI
- NPI 1346227626
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1235100991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 E ELM ST",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054871",
"telephone_number": "208-370-7004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 E ELM ST",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054871",
"telephone_number": "208-370-7004"
}
],
"practiceLocations": [
{
"address_1": "2825 Siena Heights Dr",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NV",
"postal_code": "89052",
"country_code": "US",
"telephone_number": "702-617-1227",
"fax_number": "702-492-9574",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "JOSIAH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ID",
"license": "PA-2166",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA939",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-2166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235100991",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100507371",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "100508544",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.