NPIMap

Individual provider Active NPI

Paul Robert Smith, D.P.M.

  • Sports Medicine Podiatrist
  • Lebanon, NH
National Provider Identifier
1275712390
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
License
0378 Issued in NH
Practice address
10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone
(603) 448-3121
NPI assigned
Oct 25, 2007
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0378 NH
Foot & Ankle Surgery Podiatrist 213ES0103X 0560000181 VT
Foot Surgery Podiatrist 213ES0131X 0378 NH
Sports Medicine Podiatrist 213ES0000X 0378 NH Primary

Addresses

Primary practice location

10 Alice Peck Day Dr
Lebanon, NH 03766-2900

Mailing address

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

Other practice location 1

12 Shippee Lane
Sharon, VT 05065-0506
Phone (802) 763-8000

Other practice location 2

44 S Main St
Randolph, VT 05060-1381
Phone (802) 728-7000

Other practice location 3

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090609000396 VT Practitioner - Podiatry 5092865246 Reassigns benefits to 1 organization
I20220202000891 NH Practitioner - Podiatry 5092865246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Peck Day Memorial HospitalGroup PAC ID 6103737531, 132 clinicians

Practice addresses (Care Compare)

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

5 Alice Peck Day Dr
Lebanon, NH 03766-2901
Phone (603) 448-3122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0560000181VTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital CurrentSince Jan 25, 2022 Accepting new patients
Gifford Medical Center Inc CurrentSince Jul 13, 2009 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Jan 25, 2022 Accepting new patients
Gifford Medical Center Inc. CurrentSince Jul 13, 2009 Accepting new patients

Locations

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

44 S Main St
Randolph, VT 05060
Phone (802) 728-4441

Interoperability endpoints

  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: psmith462400@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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 8

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1275712390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662900",
            "telephone_number": "603-448-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662900",
            "telephone_number": "603-448-3121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Shippee Lane",
            "address_purpose": "LOCATION",
            "city": "Sharon",
            "state": "VT",
            "postal_code": "050650506",
            "country_code": "US",
            "telephone_number": "802-763-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44 S Main St",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "VT",
            "postal_code": "050601381",
            "country_code": "US",
            "telephone_number": "802-728-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "0378",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VT",
            "license": "0560000181",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NH",
            "license": "0378",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NH",
            "license": "0378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.