Individual provider Active NPI

Ian Michael Smith, DO

  • Family Medicine Physician
  • Robbinsville, NJ
National Provider Identifier
1255081527
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB12647400 Issued in NJ
Practice address
17 Main St Ste 103
Robbinsville, NJ 08691-1438
Phone
(609) 392-6366
Fax
(732) 463-5503
NPI assigned
Mar 28, 2022
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB12647400 NJ Primary

Addresses

Primary practice location

17 Main St Ste 103
Robbinsville, NJ 08691-1438

Mailing address

17 Main St Ste 103
Robbinsville, NJ 08691-1438
Phone (609) 392-6366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250923003803 NJ Practitioner - Family Practice 1759886534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

17 Main St
Suite 103
Robbinsville, NJ 08691-1438
Phone (609) 392-6366

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Family Medicine CurrentSince Jul 11, 2025 Accepting new patients
Virtua Medical Group, PA Family Medicine PastSince Apr 1, 2022 Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

17 Main St
Ste 103
Robbinsville, NJ 08691
Phone (609) 392-6366

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Organizations & group practices 2

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.

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1255081527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MAIN ST STE 103",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086911438",
            "telephone_number": "609-392-6366",
            "fax_number": "732-463-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MAIN ST STE 103",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086911438",
            "telephone_number": "609-392-6366",
            "fax_number": "732-463-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB12647400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsville, NJ

Sources for this page

Verify at the official NPI Registry.