Scott Michael Smith, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 9101218 Issued in FL

Practice address

1395 N Courtenay Pkwy
Suite 208
Merritt Island, FL 32953-4400

Phone

(321) 529-7300

Fax

(321) 877-1136

NPI assigned

Apr 16, 2010

Last updated

Nov 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 1, 2024 through Nov 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1285950188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 FAWN LILY CT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327666611",
            "telephone_number": "732-456-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY",
            "address_2": "SUITE 208",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534400",
            "telephone_number": "321-529-7300",
            "fax_number": "321-877-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9101218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Smirnov, D.C., FICPA
• Carrie Smith
• Charles Smith III, EMS
• Dorothy Smith, DPT, PT
• Nancy L Smith, LPN
• Sierra Paige Smith
• Stephanie Anne Smith, APRN
• Kristine Soares
• Solaris Healthcare Merritt Island LLC
• Solaris Senior Living of Merritt Island LLC

• Medical Physician Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.