NPIMap

Individual provider Active NPI

Jason Michael Smuckler

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1366904427
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO3326 Issued in NV
Practice address
10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982
Phone
(702) 853-3561
Fax
(702) 563-3474
NPI assigned
Apr 5, 2019
Last updated
May 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO3326 NV Primary

Addresses

Primary practice location

10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982

Mailing address

10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230323003106 NV Practitioner - Internal Medicine 9931435096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.15 of 100Reported as group
Quality
36.67
Improvement activities
40
Cost
61.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3326NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Platinum Hospitalists LLP Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Henderson Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1366904427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE STE A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "fax_number": "702-563-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE STE A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-853-3561",
            "fax_number": "702-563-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUCKLER",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO3326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.