Organization Active NPI

George P. Smith M.D.,P.C.

  • Specialist
  • Staten Island, NY
National Provider Identifier
1487718656
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
204803 Issued in NY
Legal business name
GEORGE P. SMITH M.D.,P.C.
Practice address
405 Arden Ave
Staten Island, NY 10312-1218
Phone
(718) 608-1111
Fax
(718) 608-1112
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Dr. George Philip Smith, M.D.NPI 1205801982
Title
President
Phone
(718) 608-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 204803 NY Primary

Addresses

Primary practice location

405 Arden Ave
Staten Island, NY 10312-1218

Mailing address

405 Arden Ave
Staten Island, NY 10312-1218
Phone (718) 608-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001832 NY Part B Supplier - Clinic/Group Practice 3476445677 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1487718656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ARDEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121218",
            "telephone_number": "718-608-1111",
            "fax_number": "718-608-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ARDEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121218",
            "telephone_number": "718-608-1111",
            "fax_number": "718-608-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE P. SMITH M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-608-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "204803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.