Individual provider Active NPI

Douglas Smego, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1386677631
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
135757 Issued in NY
Practice address
1190 5TH Ave
Box 1028
New York, NY 10029-6503
Phone
(212) 659-6800
Fax
(212) 659-6818
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 135757 NY Primary

Addresses

Primary practice location

1190 5TH Ave
Box 1028
New York, NY 10029-6503

Mailing address

1190 5TH Ave
Box 1028
New York, NY 10029-6503
Phone (212) 659-6800

Other identifiers 1

IdentifierTypeStateIssuer
01188169MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1386677631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE",
            "address_2": "BOX 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-659-6800",
            "fax_number": "212-659-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE",
            "address_2": "BOX 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-659-6800",
            "fax_number": "212-659-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEGO",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "135757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01188169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.