NPIMap

Individual provider Active NPI

Rudyard Uriah Smith, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1295784031
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036053241 Issued in IL
Practice address
1514 E 87TH St
Chicago, IL 60619-6525
Phone
(773) 978-0757
Fax
(773) 978-0705
NPI assigned
May 9, 2006
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202250 IN
Internal Medicine Physician 207R00000X 036053241 IL Primary

Addresses

Primary practice location

1514 E 87TH St
Chicago, IL 60619-6525

Mailing address

539 Saint Andrews Dr
Schererville, IN 46375-2951
Phone (219) 937-9653

Other practice location 1

3510 W 79th St
Chicago, IL 60652-1430
Phone (773) 978-0757

Other identifiers 5

IdentifierTypeStateIssuer
036053241OtherILLICENSE NUMBER
01037640AOtherINLICENSE NUMBER
036053241001MedicaidIL
200414450AMedicaidIN
21627739OtherILBLUE CROSS ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsmithmdsc@direct.practicefusion.com Health Information Exchange (HIE) RUDYARD SMITH MD AND ASSOCIATES SC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20031223000793 IL Practitioner - Internal Medicine 5698673937 Reassigns benefits to 2 organizations
I20040922000787 IN Practitioner - Internal Medicine 5698673937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1975
Medicare assignment
May accept Medicare assignment
Group practices
Rudyard Smith MD and Associates SCGroup PAC ID 2567360803, 4 clinicians
Lakeshore Home Visiting PhysiciansGroup PAC ID 8123497963, 2 clinicians
American Medical Associates LLCGroup PAC ID 8224006721, 3 clinicians

Practice addresses (Care Compare)

1514 E 87TH St
Chicago, IL 60619-6525
Phone (773) 978-0757

5232 N Sheridan Rd
Chicago, IL 60640-2513
Phone (773) 654-3326

9250 Columbia Ave
Suite 1F
Munster, IN 46321-3530
Phone (219) 937-9653

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053241ILMDInternal Medicine Physician
202250INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rudyard Smith MD and Associates SC Internal Medicine CurrentSince Sep 29, 2005 Accepting new patients
Seby S C Past Accepting new patients
Accusci Labs Inc PastSince Jun 1, 2011 Accepting new patients

Locations

1514 E 87th St
Chicago, IL 60619
Phone (773) 978-0757

3510 W 79th St
Chicago, IL 60652
Phone (773) 978-0703

7906 S Crandon Ave
Chicago, IL 60617
Phone (312) 842-7580

7906 S Crandon Ave
#5
Chicago, IL 60617
Phone (773) 978-0757

7906 S Crandon Ave
Ste 5
Chicago, IL 60617
Phone (773) 978-0757

Interoperability endpoints

  • Direct secure messaging: rsmith278378@direct.myadvocateaurora.org
  • Direct secure messaging: rsmith64240@direct.franciscanalliance.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Quality Home Care Services LTDChicago, IL, CCN 147606 Home health agency W-2 Managing Employee Feb 15, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 11

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1295784031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 SAINT ANDREWS DR",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463752951",
            "telephone_number": "219-937-9653",
            "fax_number": "219-937-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 E 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196525",
            "telephone_number": "773-978-0757",
            "fax_number": "773-978-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3510 W 79th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606521430",
            "country_code": "US",
            "telephone_number": "773-978-0757",
            "fax_number": "773-978-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RUDYARD",
        "middle_name": "URIAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "202250",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "036053241",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01037640A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053241001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200414450A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "21627739",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsmithmdsc@direct.practicefusion.com",
            "affiliation": "Y",
            "endpointDescription": "EMR message center",
            "affiliationName": "RUDYARD SMITH MD AND ASSOCIATES SC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf, digital xml format",
            "address_1": "1514 E 87th St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606196525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.