Individual provider Active NPI

Smriti Prasad

  • MOHS-Micrographic Surgery Physician
  • Odessa, TX
National Provider Identifier
1316568538
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
V4728 Issued in TX
Practice address
4120 San Antonio St.
Odessa, TX 79765
Phone
(432) 333-9200
Fax
(432) 333-9300
NPI assigned
Apr 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X V4728 TX
MOHS-Micrographic Surgery Physician 207ND0101X V4728 TX Primary

Addresses

Primary practice location

4120 San Antonio St.
Odessa, TX 79765

Mailing address

4120 San Antonio St
Odessa, TX 79765
Phone (432) 333-9200

Other identifiers 1

IdentifierTypeStateIssuer
0049204MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240821003218 OH Practitioner - Dermatology 5799188868
I20250908004068 TX Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 5799188868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
University of Texas Southwestern Medical School at Dallas, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4120 San Antonio St
Odessa, TX 79765
Phone (432) 333-9200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision42
Removal of tissue1-10
Removal of skin lesions138
Removal of skin cancer192
Removal of nail tissue1-10
Skin biopsy92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V4728TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Smriti Prasad MD MPH Dermatology CurrentSince Aug 25, 2025 Accepting new patients

Organizations & group practices 1

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1316568538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 SAN ANTONIO ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79765",
            "telephone_number": "432-333-9200",
            "fax_number": "432-333-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 SAN ANTONIO ST.",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79765",
            "telephone_number": "432-333-9200",
            "fax_number": "432-333-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "SMRITI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V4728",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "V4728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049204",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.