Jack E Smith, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD034721E Issued in PA

Practice address

5750 Centre Ave
Suite 510
Pittsburgh, PA 15206-3721

Phone

(412) 924-1100

Fax

(412) 924-1111

NPI assigned

Apr 1, 2006

Last updated

Mar 13, 2014By the provider in NPPES

Sex

Male

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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cardiovascular Disease Specialists of Pittsburgh, PC

  • Specialist
  • Pittsburgh, PA
  • NPI 1972536985
  Medicare reassignment NPD Authorized official
• Laser Eye Surgery of Erie, Inc

  • Ophthalmology Physician
  • Erie, PA
  • NPI 1588751713
  NPD (past)
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1437110939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 CENTRE AVE",
            "address_2": "SUITE 510",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063709",
            "telephone_number": "412-924-1100",
            "fax_number": "412-924-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 CENTRE AVE",
            "address_2": "SUITE 510",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063721",
            "telephone_number": "412-924-1100",
            "fax_number": "412-924-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD034721E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "00060300",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00290974",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001042460006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Smith, PA-C
• Gregory T Smith, M.D.
• Gregory William Smith, DPT
• Hannah Elizabeth Abegg Smith
• Irina Smith
• Jackie Smith
• Jaclyn Smith
• Jacob Smith, PA-C
• Jake Seiko Smith
• Jamie Smith

• Specialist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.