Puddle Dock Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PUDDLE DOCK PEDIATRICS PLLC

Practice address

200 Griffin Rd Ste 12a
Portsmouth, NH 03801-7145

Phone

(603) 457-7040

NPI assigned

Oct 12, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Alyssa Reyes Smith, MDNPI 1336567213

Title

Owner/Physician

Phone

(603) 457-7040

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alyssa Reyes Smith, M.D.

  • Pediatrics Physician
  • Portsmouth, NH
  • NPI 1336567213

  Single Specialty

  NPD Authorized official
• Walter Arnold Hoerman, MD

  • Pediatrics Physician
  • Portsmouth, NH
  • NPI 1255445516
  NPD (past)

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1376324533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GRIFFIN RD STE 12A",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRIFFIN RD STE 12A",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017145",
            "telephone_number": "603-457-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUDDLE DOCK PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "REYES",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "603-457-7040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Pediatrics Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.