Roberta Smith, DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD05004674L Issued in PA

Practice address

333 Cottman Ave
Philadelphia, PA 19111-2434

Phone

(215) 728-3675

NPI assigned

Apr 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• HR Physician Services

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Meadowbrook, PA
  • NPI 1699775296
  NPD (past)
• Temple Faculty Practice Plan Inc

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1285116228
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1396700191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-728-2040",
            "fax_number": "215-728-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-3675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19111",
            "country_code": "US",
            "telephone_number": "215-728-2040",
            "fax_number": "215-728-2064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERTA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD05004674L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015097230005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall N Smith, MD
• Raymond Andrew Smith, MD
• Rebecca Lynn Hicks Smith, MSW
• Renee Smith, L.S.W.
• Robert Vincent Smith, M.D.
• Robyn Allen Smith, LCSW
• Ronald S Smith Jr.
• Ronell Aleita Smith
• Rosalind Smith
• Rosilyn Tyson Smith, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.