Individual provider Active NPI

Ryan Marshall Smith, M.D.

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1376802710
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125408 Issued in FL
Practice address
1243 S Myrtle Ave
Clearwater, FL 33756-3469
Phone
(727) 442-3126
Fax
(727) 287-4559
NPI assigned
May 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME125408 FL Primary

Addresses

Primary practice location

1243 S Myrtle Ave
Clearwater, FL 33756-3469

Mailing address

1243 S Myrtle Ave
Clearwater, FL 33756-3469
Phone (727) 442-3126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151029001950 FL Practitioner - Family Practice 0446569636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1243 S Myrtle Ave
Optum Myrtle
Clearwater, FL 33756-3469
Phone (727) 442-3126

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Aug 25, 2015 Accepting new patients
Optumcare Florida LLC Family Medicine CurrentSince Aug 25, 2015 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1100 S Fort Harrison Ave
Clearwater, FL 33756
Phone (727) 442-3126

1243 S Myrtle Ave
Clearwater, FL 33756
Phone (727) 442-3126

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ryan.smith@wellmed.eclinicaldirectplus.com

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": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1376802710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 S MYRTLE AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563469",
            "telephone_number": "727-442-3126",
            "fax_number": "727-287-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 S MYRTLE AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563469",
            "telephone_number": "727-442-3126",
            "fax_number": "727-287-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "middle_name": "MARSHALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.