Matthew Thomas Smetanick, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

N4111 Issued in TX

Practice address

200 John Hoover Pkwy
BLDG 4, Suite B
Burnet, TX 78611

Phone

(512) 930-3909

Fax

(512) 869-5868

NPI assigned

Jan 23, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Seton Highland Lakes Hospital, Burnet, TX, CCN 451365

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1366018848
  Medicare reassignment Care Compare group NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Dermatology Associates,P.C.

  • Specialist
  • Tigard, OR
  • NPI 1851442461
  NPD (past)
• Northampton Clinic Company LLC

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1538254131

  Dermatology

  NPD (past)
• Northampton Clinic Company LLC

  • Hematology & Oncology Physician
  • Bethlehem, PA
  • NPI 1952633596
  NPD (past)

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

• Ascension Seton

  • Critical Access Hospital
  • Burnet, TX
  • NPI 1003833013
  Care Compare affiliation

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1306023114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331302",
            "telephone_number": "512-930-3909",
            "fax_number": "512-869-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOHN HOOVER PKWY",
            "address_2": "BLDG 4, SUITE B",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "78611",
            "telephone_number": "512-930-3909",
            "fax_number": "512-869-5868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Highway 71 W",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "TX",
            "postal_code": "786023727",
            "country_code": "US",
            "telephone_number": "512-321-9400",
            "fax_number": "512-321-4343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1309 Mormon Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Marble Falls",
            "state": "TX",
            "postal_code": "786544602",
            "country_code": "US",
            "telephone_number": "830-798-1144",
            "fax_number": "830-201-4106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMETANICK",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS014480",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N4111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "N4111",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seton Healthcare Family
• Seton Highland Lakes Home Health, LLC
• Seton Medical Group
• Anne M. Shedlosky, DDS
• Shri Gokul Drugs LLC
• Jacob T. Smigel, D.O.
• Laura Louise Smith
• Stephanie Rashea Smith, ED.D., LPC, LSSP
• Thomas Smith, MD
• Violet Cardoza Somera, APRN AGNP-C

• Dermatology Physician in Burnet, TX
• Providers in Burnet, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.