Jeannine R. Smith, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003338-1 Issued in NY

Practice address

100 Patriots Rd
Stony Brook, NY 11790-3318

Phone

(631) 444-8608

Fax

(631) 444-8778

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1528105095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8608",
            "fax_number": "631-444-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PATRIOTS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903318",
            "telephone_number": "631-444-8608",
            "fax_number": "631-444-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEANNINE",
        "middle_name": "R.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003338-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Smales
• Lesley Small-Harary, MD
• Chrysa Smalley, NP
• Smith Point Acupuncture PC
• Barbara A Smith, ANP
• Lachlan McGalliard Smith, M.D.
• Nikeda Marie Smith, PA
• Peter Smith, D.P.M.
• Suzette Catherine Smookler, M.S., R.D., CDN
• Karen Victoria Smrek, NP

• Physician Assistant in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.