Individual provider Active NPI

Alexander Smith, PSYD

  • Psychologist
  • Madison, WI
National Provider Identifier
1346790334
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3408 Issued in WI
Practice address
2202 S Park St
Madison, WI 53713-1916
Phone
(608) 443-5480
Fax
(608) 443-5534
NPI assigned
Oct 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3408 WI Primary

Addresses

Primary practice location

2202 S Park St
Madison, WI 53713-1916

Mailing address

2901 W Beltline Hwy
Suite 120
Madison, WI 53713-4226
Phone (608) 443-5500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asmith745307@direct.uwhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161024000114 WI Practitioner - Clinical Psychologist 0446538664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health Centers IncGroup PAC ID 0345153672, 69 clinicians

Practice addresses (Care Compare)

1102 S Park St
Madison, WI 53715-1708
Phone (608) 263-3111

2202 S Park St
Madison, WI 53713-1916
Phone (608) 443-5480

3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3408WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Centers, Inc. CurrentSince Oct 31, 2016 Accepting new patients
Access Community Health Centers, Inc. CurrentSince Oct 31, 2016 Accepting new patients

Locations

3434 E Washington Ave
Madison, WI 53704
Phone (608) 443-5480

2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500

2202 S Park St
Madison, WI 53713
Phone (608) 443-5480

Interoperability endpoints

  • Direct secure messaging: bshields790677@direct.uwhealth.org
  • Direct secure messaging: asmith745307@direct.uwhealth.org

Organizations & group practices 2

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1346790334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BELTLINE HWY",
            "address_2": "SUITE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134226",
            "telephone_number": "608-443-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131916",
            "telephone_number": "608-443-5480",
            "fax_number": "608-443-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALEXANDER",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asmith745307@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2202 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537131916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.