Timothy D Smith, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4778 Issued in AZ

Practice address

15215 S 48TH St
Suite 113
Phoenix, AZ 85044-9142

Phone

(480) 961-9299

Fax

(480) 961-1802

NPI assigned

Nov 8, 2007

Last updated

Oct 19, 2023By 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 3

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America- Arizona, PC

  • Emergency Medicine Physician
  • Chandler, AZ
  • NPI 1780202804
  Medicare reassignment NPD
• Emcare - PNX Emergency Physicians LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1902855992
  Medicare reassignment
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment
• Medical Services of Prescott, Inc.

  • Emergency Medicine Physician
  • Prescott, AZ
  • NPI 1508816257
  Medicare reassignment
• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment
• Scottsdale Physicians Group PLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1689799579
  Medicare reassignment
• Cep America - Arizona PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1356021190
  NPD
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1487834297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7975 N HAYDEN RD",
            "address_2": "STE D354",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583243",
            "telephone_number": "480-214-9720",
            "fax_number": "480-214-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST",
            "address_2": "SUITE 113",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449142",
            "telephone_number": "480-961-9299",
            "fax_number": "480-961-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4778",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104364",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264533500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Smith
• Teodora Smith
• Terence Smith, DC
• Therese M Smith, MAED- LISAC
• Tiffany Smith, NP
• Todd Alan Smith, N.M.D.
• Tracey L Smith, PMHNP
• Travis Dale Smith, LPC
• Travis J Smith, PA-C
• Trent H. Smith, M.D.

• Surgical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.