Maryellen Warro Smith, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04930 Issued in TX

Practice address

5414 S Broadway Ave
Tyler, TX 75703-1335

Phone

(903) 581-1601

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 16

Other names 1

• Maryellen Warro Former name

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Mother Frances Hospital Regional Health Care CenterGroup PAC ID 9234025636, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Choice Homecare Home health agency, Tyler, TX, CCN 458261
• Christus Homecare Home health agency, Tyler, TX, CCN 743197
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Medicare reassignment
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1922058304
  NPD (past)

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

• Integrity Family Home Care LLC

  • Home Health Agency
  • Tyler, TX
  • NPI 1699009803
  Care Compare affiliation
• LHCG Cxii, LLC

  • Home Health Agency
  • Tyler, TX
  • NPI 1669994471
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1275648834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 S DONNYBROOK AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014236",
            "telephone_number": "903-597-3140",
            "fax_number": "903-595-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031335",
            "telephone_number": "903-581-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARYELLEN",
        "middle_name": "WARRO",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8544ND",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-1976930-005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8547ND",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337319301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-048",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-044",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8545ND",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337319303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8546ND",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337319302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337319304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELLEN",
            "last_name": "WARRO",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Larissa Smith, LCSW
• Lewis G Smith III, MD
• Margaret Jan Smith, RN, MSN, FNP-C
• Mary Suzanne Smith
• Maryah Smith
• Melody Rene Smith, PHARMD
• Molly Smith
• Monte Keith Smith, D.O.
• Smith, Ogletree, Smith General Partnership
• Robert Wayne Smith Jr., MD

• Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.