Individual provider Active NPI

Martha Smith, MD

  • Pediatrics Physician
  • Kingston, NY
National Provider Identifier
1366493736
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
193364 Issued in NY
Practice address
9 Family Practice Dr
Kingston, NY 12401-6449
Phone
(845) 229-9055
Fax
(845) 339-2310
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 193364 NY Primary

Addresses

Primary practice location

9 Family Practice Dr
Kingston, NY 12401-6449

Mailing address

279 Main St
Suite 204
New Paltz, NY 12561-1623
Phone (845) 255-3046

Other identifiers 1

IdentifierTypeStateIssuer
01439885MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071022000435 NY Practitioner - Pediatric Medicine 8729174750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
State University of New York at Buffalo School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Jan 16, 2024 Accepting new patients
The Institute for Family Health Past Accepting new patients

Locations

1 Family Practice Dr
Kingston, NY 12401
Phone (845) 338-2562

279 Main St
Ste 101
New Paltz, NY 12561
Phone (845) 255-2930

279 Main St
Ste 204
New Paltz, NY 12561
Phone (845) 255-3046

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1366493736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MAIN ST",
            "address_2": "SUITE 204",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611623",
            "telephone_number": "845-255-3046",
            "fax_number": "845-255-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 FAMILY PRACTICE DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016449",
            "telephone_number": "845-229-9055",
            "fax_number": "845-339-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "193364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01439885",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.