Individual provider Active NPI

Matthew Kirk Smith, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1275984965
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0116029433 Issued in VA
Practice address
35 E 21St St FL 7
New York, NY 10010-6212
Phone
(888) 663-6331
NPI assigned
Jun 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32110201 NY
Family Medicine Physician 207Q00000X 0116029433 VA Primary

Addresses

Primary practice location

35 E 21St St FL 7
New York, NY 10010-6212

Mailing address

129 W 29TH St FL 10
New York, NY 10001-5105
Phone (415) 658-6791

Other practice location 1

RAF Lakenheath 48 MDG/SGHC
Unit 5115
Apo, AE 09461-5115
Phone (163) 852-8124

Other practice location 2

9300 DeWitt Loop
Fort Belvoir, VA 22060-5285
Phone (571) 231-3224

Other practice location 3

35 E 21st St Fl 7
New York, NY 10010-6212
Phone (888) 663-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230817000140 NY Practitioner - Family Practice 1153783543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32110201NYMDFamily Medicine Physician
0116029433VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Family Medicine CurrentSince Aug 14, 2023 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1275984965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W 29TH ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015105",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E 21ST ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106212",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "RAF Lakenheath 48 MDG/SGHC",
            "address_2": "Unit 5115",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "094615115",
            "country_code": "US",
            "telephone_number": "163-852-8124",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "9300 DeWitt Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Belvoir",
            "state": "VA",
            "postal_code": "220605285",
            "country_code": "US",
            "telephone_number": "571-231-3224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 E 21st St Fl 7",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100106212",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "32110201",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116029433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.