Individual provider Active NPI

Ellen Smith

  • Pediatrics Physician
  • Seneca, PA
National Provider Identifier
1386079804
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD447921 Issued in PA
Practice address
100 Fairfield Dr
Seneca, PA 16346-2130
Phone
(814) 676-7863
NPI assigned
Sep 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD447921 PA Primary

Addresses

Primary practice location

100 Fairfield Dr
Seneca, PA 16346-2130

Mailing address

100 Fairfield Dr
Seneca, PA 16346-2130

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200804003502 PA Practitioner - Pediatric Medicine 4981029139 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD447921PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc Pediatrics CurrentSince Aug 1, 2020 Accepting new patients
Upmc Northwest Past Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

100 Fairfield Dr
Seneca, PA 16346
Phone (814) 676-7600

Interoperability endpoints

  • Direct secure messaging: upmchospitals@upmcdirect.com
  • Direct secure messaging: esmith516620@upmc.direct-ci.com

Organizations & group practices 2

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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1386079804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FAIRFIELD DR",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163462130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FAIRFIELD DR",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163462130",
            "telephone_number": "814-676-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2021-05-24",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD447921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seneca, PA

Sources for this page

Verify at the official NPI Registry.