Individual provider Active NPI

Philip G Smith, MD

  • Surgery Physician
  • Richland, WA
National Provider Identifier
1508966581
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60119652 Issued in WA
Practice address
1100 Goethals Drive 2ND Floor
Kadlec Clinic General & Colorectal Surgery
Richland, WA 99352-3304
Phone
(509) 942-3185
Fax
(509) 946-1850
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60119652 WA Primary

Addresses

Primary practice location

1100 Goethals Drive 2ND Floor
Kadlec Clinic General & Colorectal Surgery
Richland, WA 99352-3304

Mailing address

3900 S Zintel Way
Kennewick, WA 99338
Phone (509) 942-3627

Other identifiers 3

IdentifierTypeStateIssuer
8563785MedicaidWA
00G848590MedicaidCA
258395OtherWALABOR & INDUSTRIES

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address psmith1108112@wm.providencedirect.org
Direct Messaging Address psmith1108112@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100226000869 WA Practitioner - General Surgery 1658445671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

780 Swift Blvd
Richland, WA 99352-3524

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60119652WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Blessings Birth Center Past Accepting new patients

Locations

3900 S Zintel Way
Kennewick, WA 99337
Phone (509) 942-3125

945 Goethals Dr
Ste 200
Richland, WA 99352
Phone (509) 942-2555

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

780 Swift Blvd
Ste 101
Richland, WA 99352
Phone (509) 942-3060

1100 Goethals Dr
Fl 2
Richland, WA 99352
Phone (509) 942-3178

1100 Goethals Dr
Ste D
Richland, WA 99352
Phone (509) 942-3057

780 Swift Blvd
Ste 130
Richland, WA 99352
Phone (509) 942-3244

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1096 Goethals Dr
Richland, WA 99352
Phone (509) 743-9700

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1508966581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S ZINTEL WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99338",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GOETHALS DRIVE 2ND FLOOR",
            "address_2": "KADLEC CLINIC GENERAL & COLORECTAL SURGERY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523304",
            "telephone_number": "509-942-3185",
            "fax_number": "509-946-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHILIP",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60119652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8563785",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G848590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "258395",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psmith1108112@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "780 Swift Blvd Ste 101",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psmith1108112@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1096 Goethals Dr",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.