NPIMap

Individual provider Active NPI

Steven W Smith, MD

  • Emergency Medicine Physician
  • Kodiak, AK
National Provider Identifier
1457462335
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2812 Issued in AK
Practice address
1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone
(907) 486-3281
Fax
(907) 486-9546
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2812 AK Primary

Addresses

Primary practice location

1915 E Rezanof Dr
Kodiak, AK 99615-6602

Mailing address

1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 486-3281

Other identifiers 2

IdentifierTypeStateIssuer
2812OtherAKLICENSE NUMBER
MD2812MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssmith20384@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100721000832 AK Practitioner - Family PracticePractitioner - Emergency Medicine 5890827133 Reassigns benefits to 1 organization
I20230522003121 TX Practitioner - Emergency MedicinePractitioner - Family Practice 5890827133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Kodiak Island Health Care FoundationGroup PAC ID 8022922509, 15 clinicians

Practice addresses (Care Compare)

1911 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 481-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2812AKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association CurrentSince May 1, 2023 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jun 30, 2023 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Kodiak Island Health Care Foundation CurrentSince Feb 27, 2024 Accepting new patients
Maniilaq Association CurrentSince May 1, 2023 Accepting new patients
Maniilaq Association Current Accepting new patients

Locations

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

1911 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 481-2484

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457462335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-486-3281",
            "fax_number": "907-486-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-486-3281",
            "fax_number": "907-486-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEVEN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AK",
            "license": "2812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2812",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2812",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmith20384@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1915 E Rezanof Dr",
            "city": "Kodiak",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996156602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

Verify at the official NPI Registry.