Tiffany Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA189566 Issued in OR

Practice address

3860 Crater Lake Ave Ste a
Medford, OR 97504-9741

Phone

(541) 858-1003

Fax

(541) 857-4499

NPI assigned

Nov 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergy and Asthma Center of Southern Oregon, PCGroup PAC ID 1355449141, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Allergy & Asthma Center of Southern Oregon PC

  • Allergy Physician
  • Medford, OR
  • NPI 1760548408
  Medicare reassignment Care Compare group
• Allergy & Asthma Center of Southern Oregon PC

  • Allergy Physician
  • Roseburg, OR
  • NPI 1851954853
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1467995530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CRATER LAKE AVE STE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049741",
            "telephone_number": "541-858-1003",
            "fax_number": "541-857-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 CRATER LAKE AVE STE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049741",
            "telephone_number": "541-858-1003",
            "fax_number": "541-857-4499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Lang Ave NE",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871094495",
            "country_code": "US",
            "telephone_number": "505-994-9572",
            "fax_number": "505-883-0725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIFFANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2016-0100",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA189566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marguerite Jean Smith, ANP
• Matthew Thomas Smith, PA
• Rebecca Smith
• Sara Anne Smith, RN
• Susan E Smith, MD
• Timothy James Smith
• Tricia Leannie Smith, MS PSYCHOLOGIST ASSO
• Walter Devin Smith, P.M.H.N.P.
• SMJ Consulting, Inc
• Heather M Smothers, CADC-R

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.