John Gerard Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0571 Issued in NH

Practice address

185 Queen City Ave
Manchester, NH 03101-7121

Phone

(603) 627-1102

Fax

(603) 647-5524

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elliot Hospital Hospital, Manchester, NH, CCN 300012
• Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smith.john.wdh@direct.partners.masshiway.net

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935
  Medicare reassignment Care Compare group
• Wentworth Douglass Physician Corporation

  • Magnetic Resonance Imaging Radiologic Technologist
  • Dover, NH
  • NPI 1447352430
  Medicare reassignment Care Compare group
• Wentworth Douglass Hospital

  • General Acute Care Hospital
  • Portsmouth, NH
  • NPI 1528687829
  NPD
• Wentworth Douglass Physician Corporation

  • Diagnostic Radiology Physician
  • Somersworth, NH
  • NPI 1295326494
  NPD
• Wentworth Douglass Physician Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Dover, NH
  • NPI 1710504683
  NPD
• Portsmouth Emergency Physicians PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Portsmouth, NH
  • NPI 1710923511
  NPD (past)

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

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation
• Wentworth Douglass Hospital

  • General Acute Care Hospital
  • Dover, NH
  • NPI 1033118104
  Care Compare affiliation
• Wentworth Douglass Hospital

  • Diabetes Educator Registered Nurse
  • Dover, NH
  • NPI 1407385198

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1427095728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-627-1102",
            "fax_number": "603-647-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-627-1102",
            "fax_number": "603-647-5524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2531 White Mountain Hwy",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Sanbornville",
            "state": "NH",
            "postal_code": "038724429",
            "country_code": "US",
            "telephone_number": "603-522-0186",
            "fax_number": "603-522-3457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038202526",
            "country_code": "US",
            "telephone_number": "603-740-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0157",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077022",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00331200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00394782",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320420099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Smith, LCMHC
• Jennifer Smith, BCBA
• Jessica A Smith, APRN, NP-C
• Jill Smith, LICSW
• Jodi-Ann Simone Smith
• Justin Smith, AGACNP-BC
• Kimberly Latrice Smith
• Megan Riley Smith, OTR/L
• Melanie Smith, M.S., CCC-SLP
• Michelle Smith, BA

• Physician Assistant in Manchester, NH
• Providers in Manchester, NH by specialty
• Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.