Individual provider Active NPI

David Ian Smith, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Minneapolis, MN
National Provider Identifier
1316239361
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
59986 Issued in MN
Practice address
516 15TH Ave SE Ste 190E
Minneapolis, MN 55455-0130
Phone
(612) 626-4789
NPI assigned
May 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 59986 MN Primary

Addresses

Primary practice location

516 15TH Ave SE Ste 190E
Minneapolis, MN 55455-0130

Mailing address

516 15TH Ave SE Suite 190E
Minneapolis, MN 55455-0130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20151106002002 MN Practitioner - Sports MedicinePractitioner - Family Practice 6103136924 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

10961 Club W Pkwy
Blaine, MN 55449-5869
Phone (763) 528-2987

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59986MNMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Mar 4, 2017 Accepting new patients
Fairview Health Services CurrentSince Oct 30, 2015 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Mar 4, 2017 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Oct 30, 2015 Accepting new patients
Fairview Clinics Current Accepting new patients
University of Minnesota Physicians CurrentSince Nov 21, 2016 Accepting new patients
University of Minnesota Physicians CurrentSince Nov 21, 2016 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

290 Main St NW
Ste 100
Elk River, MN 55330
Phone (763) 241-0373

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2922

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

516 15th Ave SE
Ste 190E
Minneapolis, MN 55455
Phone (612) 626-2066

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

Interoperability endpoints

  • Direct secure messaging: dsmith351229@fairview.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 7

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": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1316239361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 15TH AVE SE SUITE 190E",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 15TH AVE SE STE 190E",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550130",
            "telephone_number": "612-626-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "IAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "59986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.