Individual provider Active NPI

Ethan Andrew Smith, M.D.

  • Pediatric Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1457477358
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
35.095027 Issued in OH
Practice address
3333 Burnet Avenue
ML 5031
Cincinnati, OH 45229-3026
Phone
(513) 636-4251
Fax
(513) 636-8145
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 50483 KY
Diagnostic Radiology Physician 2085R0202X 4301086310 MI
Pediatric Radiology Physician 2085P0229X 35.095027 OH Primary

Addresses

Primary practice location

3333 Burnet Avenue
ML 5031
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Avenue
ML 5031
Cincinnati, OH 45229-3026
Phone (513) 636-4251

Other practice location 1

234 Goodman St
Cincinnati, OH 45219-2364
Phone (513) 584-7355

Other practice location 2

800 Rose St
Lexington, KY 40536-3026
Phone (859) 323-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170613002774 OH Practitioner - Diagnostic Radiology 7719155324 Reassigns benefits to 4 organizations
I20170830000335 KY Practitioner - Diagnostic Radiology 7719155324 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Medical CenterGroup PAC ID 8426955733, 716 clinicians

Practice addresses (Care Compare)

2015 Childrens Way
Union, KY 41091-7829
Phone (513) 636-4551

2765 Chapel PL
Crestview Hills, KY 41017-3413
Phone (859) 344-5390

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

3333 Burnet Ave
Cincinnati, OH 45229-3039

Hospital & facility affiliations

  • Cincinnati Children'S Hospital Medical Center Hospital, Cincinnati, OH, CCN 363300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50483KYMDPediatric Radiology Physician
4301086310MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
University of Cincinnati Physicians Company, LLC CurrentSince Aug 7, 2017 Accepting new patients
University of Kentucky Diagnostic Radiology CurrentSince Aug 31, 2023 Accepting new patients

Locations

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

68 Cavalier Blvd
Florence, KY 41042
Phone (513) 475-7630

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

151 W Galbraith Rd
Cincinnati, OH 45216
Phone (513) 418-2500

3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3113 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 475-8033

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

3333 Burnet Ave
#5031
Cincinnati, OH 45229
Phone (513) 636-4251

200 Albert Sabin Way
Cincinnati, OH 45267
Phone (513) 475-7500

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

1404 E 2nd St
Defiance, OH 43512
Phone (567) 368-1008

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

7690 Discovery Dr
West Chester, OH 45069
Phone (513) 475-7425

Organizations & group practices 4

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 1

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1457477358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 5031",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4251",
            "fax_number": "513-636-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 5031",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4251",
            "fax_number": "513-636-8145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Goodman St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192364",
            "country_code": "US",
            "telephone_number": "513-584-7355",
            "fax_number": "513-584-0431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405363026",
            "country_code": "US",
            "telephone_number": "859-323-2222",
            "fax_number": "859-323-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ETHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "KY",
            "license": "50483",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301086310",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OH",
            "license": "35.095027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.