Individual provider Active NPI

Jacqueline Marie Smith, MD

  • Obstetrics & Gynecology Physician
  • Clifton, NJ
National Provider Identifier
1255643615
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD60527099 Issued in WA
Practice address
1033 US Highway 46
Ste 102
Clifton, NJ 07013-2473
Phone
(973) 779-7979
NPI assigned
Jul 13, 2010
Last updated
May 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD60527099 WA Primary

Addresses

Primary practice location

1033 US Highway 46
Ste 102
Clifton, NJ 07013-2473

Mailing address

1033 US Highway 46
Ste 102
Clifton, NJ 07013-2473
Phone (973) 779-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, CA, AZ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180219001596 NJ Practitioner - Obstetrics/Gynecology 1052672888 Reassigns benefits to 3 organizations
I20210609001899 NY Practitioner - Obstetrics/Gynecology 1052672888 Reassigns benefits to 4 organizations
I20210709000398 CA Practitioner - Obstetrics/Gynecology 1052672888 Reassigns benefits to 1 organization
I20230525002682 AZ Practitioner - Obstetrics/Gynecology 1052672888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Memorial Hospital of William F and Gertrude F Jones IncGroup PAC ID 7012828486, shared by 8 NPIs, 130 clinicians

Practice addresses (Care Compare)

127 N Main St
Wellsville, NY 14895-1149
Phone (585) 596-0145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60527099WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology Current Accepting new patients
Womens OBGYN PC Obstetrics & Gynecology CurrentSince Jun 9, 2023 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology CurrentSince Oct 1, 2023 Accepting new patients
Community Health Care, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Magella Medical Group, Inc. Obstetrics & Gynecology CurrentSince Mar 13, 2021 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology Current Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology CurrentSince Oct 1, 2023 Accepting new patients
OBGYN Hospitalist Medical Services of New York, P.C. Obstetrics & Gynecology CurrentSince Apr 7, 2021 Accepting new patients
Community Health Care, Inc. Obstetrics & Gynecology CurrentSince Sep 1, 2021 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Obstetrical-Gynecological Associates of the Southern Tier, P.C. Obstetrics & Gynecology Current Accepting new patients
OB Hospitalist Services New Jersey, PA Obstetrics & Gynecology CurrentSince Apr 29, 2021 Accepting new patients
Charles Haddad, MD Obstetrics & Gynecology CurrentSince Jan 6, 2018 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Apr 1, 2023 Accepting new patients
HCH Tucson Holdings LLC Past Accepting new patients

Locations

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

1209 W Target Range Rd
Ste 100
Nogales, AZ 85621
Phone (520) 287-4747

1852 N Mastick Way
Nogales, AZ 85621

File 50978
Los Angeles, CA 90074

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

30 N Pearl St
Bridgeton, NJ 08302

1033 US Highway 46
Ste 102
Clifton, NJ 07013
Phone (973) 779-7979

335 Delsea Dr N
Glassboro, NJ 08028
Phone 85645147002755

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

73 Buffalo St
Ste 100
Canandaigua, NY 14424

7309 Seneca Rd N
Ste 114
Hornell, NY 14843
Phone (607) 324-0604

30 Harrison St
Ste 340
Johnson City, NY 13790
Phone (607) 763-8088

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

401 Main St
Ste 1
Johnson City, NY 13790
Phone (607) 754-9870

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

2210 Troy Schenectady Rd
Schenectady, NY 12309
Phone (518) 346-6400

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23386/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jsmith190252@ahs.direct-ci.com
  • Direct secure messaging: jsmith504270@direct.urmc.rochester.edu

Organizations & group practices 17

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.

View all 17

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1255643615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46",
            "address_2": "STE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132473",
            "telephone_number": "973-779-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46",
            "address_2": "STE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132473",
            "telephone_number": "973-779-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60527099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.