Individual provider Active NPI

Justin Smiley, DO

  • Family Medicine Physician
  • Santa Rosa Beach, FL
National Provider Identifier
1457568685
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS12346 Issued in FL
Practice address
43 Cassine Way Ste 102
Santa Rosa Beach, FL 32459-0457
Phone
(850) 231-1919
Fax
(850) 231-1918
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44001 CO
Family Medicine Physician 207Q00000X OS12346 FL Primary

Addresses

Primary practice location

43 Cassine Way Ste 102
Santa Rosa Beach, FL 32459-0457

Mailing address

43 Cassine Way Ste 102
Santa Rosa Beach, FL 32459-0457
Phone (850) 231-1919

Other identifiers 1

IdentifierTypeStateIssuer
010391100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 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
I20090204000395 CO Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 2264596329 Reassigns benefits to 2 organizations
I20131212000677 FL Practitioner - Family PracticePractitioner - Emergency Medicine 2264596329 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedgwick County Memorial HospitalGroup PAC ID 1052201100, shared by 5 NPIs, 15 clinicians
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

900 Cedar St
Julesburg, CO 80737-1121
Phone (970) 474-3323

9318 Panama City Beach Pkwy
Panama City Beach, FL 32407-4024
Phone (850) 772-6200

Hospital & facility affiliations

  • HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
  • Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313
  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Sedgwick County Memorial Hospital Hospital, Julesburg, CO, CCN 061310

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44001COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Mar 13, 2024 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Jul 3, 2024 Accepting new patients
Cep America LLC CurrentSince Mar 13, 2024 Accepting new patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola CurrentSince Apr 1, 2014 Accepting new patients
Cep America, LLC Current Accepting new patients
North Walton Rural Hospital, LLC CurrentSince Sep 23, 2024 Accepting new patients
Lakewood Ranch Anesthesia PL Past Accepting new patients
Sterling Regional Medcenter Past Accepting new patients
Apex Emergency Group, Inc Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

4413 US Highway 331 S
Defuniak Springs, FL 32435
Phone (850) 892-5171

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

9318 Panama City Beach Pkwy
Fl Gulf
Panama City Beach, FL 32407
Phone (850) 772-6200

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 11

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 4

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1457568685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CASSINE WAY STE 102",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324590457",
            "telephone_number": "850-231-1919",
            "fax_number": "850-231-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CASSINE WAY STE 102",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324590457",
            "telephone_number": "850-231-1919",
            "fax_number": "850-231-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "44001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS12346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010391100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

Verify at the official NPI Registry.