Individual provider Active NPI

John Kolton Smith, DO

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1376120725
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2140
NPI assigned
Mar 24, 2021
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X V5606 TX
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

5079 April LN
Waxahachie, TX 75165-8706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250321000116 TX Practitioner - Internal Medicine 2860937802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

3410 Worth St
Suite 300
Dallas, TX 75246-2012
Phone (214) 370-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Feb 27, 2025 Accepting new patients
Texas Oncology PA Current Accepting new patients
Texas Oncology PA CurrentSince Feb 27, 2025 Accepting new patients

Locations

3410 Worth St
Ste 300
Dallas, TX 75246
Phone (214) 370-1500

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

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

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1376120725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5079 APRIL LN",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751658706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "KOLTON",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V5606",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.