Active NPI
Justin Alan Smith, MD
- Surgery Physician
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2024-00987
- Practice address
- 11100 Euclid Ave
Cleveland, OH 44106-1716 - Phone
- (630) 335-4881
- NPI assigned
- Mar 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | 2024-00987 | NC | Primary |
Addresses
Primary practice location
11100 Euclid Ave
Cleveland, OH 44106-1716
Mailing address
11100 Euclid Ave
Cleveland, OH 44106-1716
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Medical Park Dr
Suite 210
Concord, NC 28025-2966
Phone (704) 403-6100
575 1St St
Macon, GA 31201-2825
Phone (478) 743-9762
Hospital & facility affiliations
- Carolinas Medical Center-Northeast
- Atrium Health Navicent the Medical Center
- Atrium Health University City
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 20 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024-00987 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Health Services of Central Georgia, Inc | Surgery | Current | Accepting new patients |
| Carolinas Physicians Network Inc | Current | Accepting new patients |
Locations
777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600
575 1st St
Macon, GA 31201
Phone (478) 742-7566
1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706
10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337
100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100
134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100
Interoperability endpoints
- jsmith31544@ehrdirect.uhhospitals.org
- jsmith2934257@carolinashealthcaresystem.direct-ci.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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charlotte, NC
- NPI 1477878890
-
- Multi-Specialty Clinic/Center
- Macon, GA
- NPI 1184679482
Surgery
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
- Cardiovascular Disease Physician
- Concord, NC
- NPI 1710290564
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1346297892
-
- General Acute Care Hospital
- Concord, NC
- NPI 1487866315
-
- Psychiatric Hospital Unit
- Concord, NC
- NPI 1629283866
-
- General Acute Care Hospital
- Macon, GA
- NPI 1043270564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1326508649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "630-335-4881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-22",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "2024-00987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.