Justin Reynard Smith, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

311974 Issued in NY

Practice address

1051 Riverside Dr
New York, NY 10032-1007

Phone

(646) 363-6545

Fax

(850) 220-1894

NPI assigned

Apr 16, 2019

Last updated

Jul 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688860800000",
    "number": "1376106328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 BROADWAY # 1708",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245805",
            "telephone_number": "646-363-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321007",
            "telephone_number": "646-363-6545",
            "fax_number": "850-220-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "REYNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2023-07-09",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "311974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Smith, LMHC
• Joshua Smith
• Judith R Smith, LCSW
• Julia Smith, MD
• Julianne Noelle Smith, PT, DPT
• Karen Smith
• Karenlee E Smith
• Karimah Smith, LPN
• Kashif O Smith, MD
• Katelyn Marie Smith, NP

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.