Individual provider Active NPI

Lisa Ann Smith, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Cuyahoga Falls, OH
National Provider Identifier
1447647979
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36.003816 Issued in OH
Practice address
1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone
(330) 971-7000
NPI assigned
Apr 22, 2015
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 36.003816 OH Primary

Addresses

Primary practice location

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

Mailing address

5208 Ridgebury Blvd
Lyndhurst, OH 44124-1209
Phone (614) 309-5696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180827002587 OH Practitioner - Podiatry 2365731692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Foot and Ankle Center LLCGroup PAC ID 5698921229, 9 clinicians

Practice addresses (Care Compare)

784 Medina Rd
Suite 107
Medina, OH 44256-9634
Phone (330) 591-9635

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue539
Removal of skin lesions23
Removal of nail tissue330
Removal or shaving of skin growth49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36.003816OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Foot & Ankle Center LLC Foot & Ankle Surgery CurrentSince Aug 1, 2018 Accepting new patients

Locations

1000 E Washington St
Medina, OH 44256
Phone (330) 654-1185

535 E Smith Rd
Medina, OH 44256
Phone (330) 591-9635

784 Medina Rd
Ste 107
Medina, OH 44256
Phone (330) 591-9635

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1447647979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 RIDGEBURY BLVD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441241209",
            "telephone_number": "614-309-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-971-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

Verify at the official NPI Registry.