Active NPI
Eileen A Smith, MD PA
- Psychiatry Physician
- San Antonio, TX
National Provider Identifier
1316051527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- TXJ1141
- Practice address
- 8601 Village Drive
#118
San Antonio, TX 78217 - Phone
- (210) 967-0515
- Fax
- (210) 655-9697
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | TXJ1141 | TX | Primary |
Addresses
Primary practice location
8601 Village Drive
#118
San Antonio, TX 78217
Mailing address
PO Box 34567
San Antonio, TX 78265
Phone (210) 967-0515
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099920303 | Medicaid | TX | |
| P00079579 | Other | TX | MEDICARE RAILROAD (PTAN) |
| 8R7170 | Other | TX | BCBS |
| 099920302 | Medicaid | TX |
Medicare participation
Medicare enrollment files- 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: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2014 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TXJ1141 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1316051527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34567",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78265",
"telephone_number": "210-967-0515",
"fax_number": "210-655-9697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8601 VILLAGE DRIVE",
"address_2": "#118",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78217",
"telephone_number": "210-967-0515",
"fax_number": "210-655-9697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "EILEEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "TXJ1141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099920303",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD (PTAN)",
"identifier": "P00079579",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8R7170",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099920302",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.