Kaitlin Teresa Smith, PA-C

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

25MP00689900 Issued in NJ

Practice address

475 Prospect Ave Ste 101
West Orange, NJ 07052-4197

Phone

(973) 325-2229

NPI assigned

Jan 14, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Rma of NJ

  • Reproductive Endocrinology Physician
  • Basking Ridge, NJ
  • NPI 1992712558
  NPD (past)
• Premium Health Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1609129402

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1497344311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 JACKSON ST APT 3C",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306101",
            "telephone_number": "716-982-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE STE 101",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "973-325-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Old Lincoln St Apt 15",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052660",
            "country_code": "US",
            "telephone_number": "716-982-7051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAITLIN",
        "middle_name": "TERESA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NJ",
            "license": "25MP00689900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Slutsky, DMD
• Carolyn Marie Smaka, AU.D.
• Melissa Ann Smirnow, PA-C
• Donna E. Smith, LSW, LCADC, ICADC,
• Hannah Smith, AUD
• Kayleigh Rey Smith
• Talnisha Smith, LPC
• Whitney Brooke Smith, DPT
• Paula C. Sociedade, PH.D.
• Michael Sokol, DDS

• Reproductive Endocrinology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Reproductive Endocrinology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.