Individual provider Active NPI

Jaclyn Arielle Smith, M.D.

  • Dermatology Physician
  • Naples, FL
National Provider Identifier
1235669755
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME150949 Issued in FL
Practice address
2235 Venetian Court
Suite 1
Naples, FL 34109-8728
Phone
(239) 596-9337
Fax
(239) 596-9466
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME150949 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2235 Venetian Court
Suite 1
Naples, FL 34109-8728

Mailing address

2235 Venetian Court
Suite 1
Naples, FL 34109-8728
Phone (239) 596-9337

Other practice location 1

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 938-3359

Other practice location 2

1600 S Andrews Ave
Fort Lauderdale, FL 33316
Phone (954) 355-5756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20210609002223 FL Practitioner - Dermatology 7618377813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodruff Institute LLCGroup PAC ID 1658351101, 22 clinicians

Practice addresses (Care Compare)

2235 Venetian CT
Suite 1
Naples, FL 34109-8728
Phone 2395969337610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions2627
Removal or shaving of skin growth21
Skin biopsy541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME150949FLMDDermatology Physician

Interoperability endpoints

  • Direct secure messaging: jasmith@woodruff.emadirect.md

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235669755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 VENETIAN COURT",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341098728",
            "telephone_number": "239-596-9337",
            "fax_number": "239-596-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 VENETIAN COURT",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341098728",
            "telephone_number": "239-596-9337",
            "fax_number": "239-596-9466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4725 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333084603",
            "country_code": "US",
            "telephone_number": "954-938-3359",
            "fax_number": "954-492-5790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 S Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "33316",
            "country_code": "US",
            "telephone_number": "954-355-5756",
            "fax_number": "954-712-2996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACLYN",
        "middle_name": "ARIELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME150949",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.