Individual provider Active NPI

Tanisha Leanna Smith, DPM

  • Primary Podiatric Medicine Podiatrist
  • Indianapolis, IN
National Provider Identifier
1316264187
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
07001108A Issued in IN
Practice address
5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722
Phone
(317) 653-2730
Fax
(317) 321-1935
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 07001108A IN Primary
Foot & Ankle Surgery Podiatrist 213ES0103X PO 3402 FL

Addresses

Primary practice location

5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101018000760 IN Practitioner - Podiatry 3678766045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

Practice addresses (Care Compare)

5926 Crawfordsville Rd
B
Speedway, IN 46224-3722
Phone (317) 653-2730

7343 Clearvista Dr
Indianapolis, IN 46256-4602
Phone (317) 397-1718

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue53
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3402FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Angelic Footcare Primary Podiatric Medicine CurrentSince Jun 28, 2015 Accepting new patients
Oak Street Health Physicians Group, PC PastSince Apr 30, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7343 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 585-5400

Interoperability endpoints

  • Direct secure messaging: tanisha.smith@oakstreethealth.gwaydirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1316264187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5926 CRAWFORDSVILLE RD UNIT B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243722",
            "telephone_number": "317-653-2730",
            "fax_number": "317-321-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TANISHA",
        "middle_name": "LEANNA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IN",
            "license": "07001108A",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.