Individual provider Active NPI

Jan E. Smolen, D.P.M.

  • Foot Surgery Podiatrist
  • Muskegon, MI
National Provider Identifier
1407813413
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
5901001917 Issued in MI
Practice address
561 Seminole Rd
Muskegon, MI 49444-3719
Phone
(231) 733-1111
Fax
(231) 733-1144
NPI assigned
Apr 26, 2006
Last updated
Dec 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 5901001917 MI Primary

Addresses

Primary practice location

561 Seminole Rd
Muskegon, MI 49444-3719

Mailing address

561 Seminole Rd
Muskegon, MI 49444-3719
Phone (231) 733-1111

Other identifiers 2

IdentifierTypeStateIssuer
4856110650OtherMIBLUE CROSS BLUE SHIELD
133524970MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000515 MI Practitioner - Podiatry 9436115565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Shoreline Foot and Ankle Associates PCGroup PAC ID 2062474778, 5 clinicians

Practice addresses (Care Compare)

561 Seminole Rd
Norton Shores, MI 49444-3719

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.52 of 100Reported as group
Quality
62.33
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Foot & Ankle Associates P.C. Foot Surgery CurrentSince Oct 21, 2004 Accepting new patients

Locations

7 Atkinson Dr
Ste 113
Ludington, MI 49431
Phone (231) 843-3700

561 Seminole Rd
Norton Shores, MI 49444
Phone (231) 722-2713

Interoperability endpoints

  • Direct secure messaging: jsmolen@shorelinefaa.emadirect.md
  • Direct secure messaging: jsmolen40752@direct.trinity-health.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1407813413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 SEMINOLE RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494443719",
            "telephone_number": "231-733-1111",
            "fax_number": "231-733-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 SEMINOLE RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494443719",
            "telephone_number": "231-733-1111",
            "fax_number": "231-733-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLEN",
        "first_name": "JAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MI",
            "license": "5901001917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4856110650",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133524970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.