Individual provider Active NPI

Sean T. Smith, MD

  • Pediatrics Physician
  • Fort Carson, CO
National Provider Identifier
1497730774
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0060438 Issued in CO
Practice address
1650 Cochrane Cir
Department of Pediatrics-Each
Fort Carson, CO 80913-4613
Phone
(719) 526-7653
Fax
(719) 526-7673
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36948 TN
Pediatrics Physician 208000000X 0060438 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir
Department of Pediatrics-Each
Fort Carson, CO 80913-4613

Mailing address

1650 Cochrane Cir
Department of Pediatrics-Each
Fort Carson, CO 80913-4613
Phone (719) 526-7653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912000327 CO Practitioner - Pediatric Medicine 4183864754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0060438COMDPediatrics Physician
36948TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Jul 28, 2018 Accepting new patients
Matthews-Vu Medical Group, P.C. Pediatrics CurrentSince Jul 28, 2018 Accepting new patients

Locations

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1497730774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "DEPARTMENT OF PEDIATRICS-EACH",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-526-7653",
            "fax_number": "719-526-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "DEPARTMENT OF PEDIATRICS-EACH",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-526-7653",
            "fax_number": "719-526-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SEAN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "36948",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "0060438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.