Tanner R Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9328 Issued in AZ

Practice address

2620 N 140TH Ave Ste 103
Goodyear, AZ 85395-2437

Phone

(623) 219-4777

Fax

(623) 219-4778

NPI assigned

Jul 20, 2022

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Sky Dermatology LLCGroup PAC ID 5496028607, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.97 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

63.24

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: tsmith@clearsky.emadirect.md

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.

• Clear Sky Dermatology LLC

  • Dermatology Physician
  • Goodyear, AZ
  • NPI 1306369996
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1477288801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE STE 103",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "623-219-4777",
            "fax_number": "623-219-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE STE 103",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "623-219-4777",
            "fax_number": "623-219-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TANNER",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marines Smith, FNP
• Jill Smith
• Josephine Ellie Smith
• Raechel Smith, LCSW
• Shannon Smith, FNP-C
• Vanessa Smith
• Weslynne Sue Smith
• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Clay Snell

• Physician Assistant in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.