Jereme Stephen Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007871 Issued in MI

Practice address

440 Woodward Ave
Iron Mountain, MI 49801-4631

Phone

(906) 776-9040

Fax

(906) 774-5950

NPI assigned

Sep 7, 2016

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmith924894@direct.emplifyhealth.org
• Direct secure messaging: jsmith267549@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509
  Medicare reassignment Care Compare group
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment
• Oconto Hospital & Medical Center Inc

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1245565878
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Seymour, WI
  • NPI 1033171723
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Oconto Hospital & Medical Center Inc

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037
  NPD
• Oconto Hospital & Medical Center, Inc.

  • Rural Health Clinic/Center
  • Oconto, WI
  • NPI 1609018589
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1487101531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-5950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREME",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COMMISSION ON CERTIFIED PHYSICIANS ASSISTANTS",
            "identifier": "1137621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DRL LICENSE",
            "identifier": "4679-23",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Sielaff, FNP-C
• Harninder Singh, MD
• Stephen C Slajus, DO
• Colleen Ann Sleik, MPT
• Elise Sloden, RRT
• Kadee Lee Smith
• Kevin Anthony Smith, RRT
• Rene K Smith, MOT, OTR/L
• Carl Ashley Smoot, DO,FCCP, DABSM
• Ann Sokop, APNP

• Physician Assistant in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.