Amanda Dawn Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006613RX Issued in OH

Practice address

1566 Monmouth Dr Ste 101
Lancaster, OH 43130-8048

Phone

(740) 687-1177

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Surgical Dermatology Inc 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score

83.85 of 100Reported as group

Promoting interoperability

81

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Center for Surgical Dermatology Inc

  • Dermatology Physician
  • Westerville, OH
  • NPI 1972532091

  OH

  Medicare reassignment Care Compare group
• CSD ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Westerville, OH
  • NPI 1821159823
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1508467010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 MONMOUTH DR STE 101",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308048",
            "telephone_number": "740-687-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 MONMOUTH DR STE 101",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308048",
            "telephone_number": "740-687-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Newark Granville Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Granville",
            "state": "OH",
            "postal_code": "430237009",
            "country_code": "US",
            "telephone_number": "740-587-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006613RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lea Slater, D.O.
• Beth Sleeper, PCC
• Tamara Slicer, FNP
• Judith Ellen Smalley, P.T.
• Aaron Smith, CDCA
• Bethany Melva Smith, PA-C
• Jessica Smith, RN
• Jessica Omega Smith
• Katie Lynn Smith, OTR/L
• Kellie Smith, LSW

• All providers in Lancaster, OH
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; 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.