Individual provider Active NPI

John T Smieska III, PA-C

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1528327376
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015573 Issued in NY
Practice address
1001 W Seneca St
Ithaca, NY 14850-3342
Phone
(607) 273-7000
Fax
(607) 273-7001
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015573 NY Primary

Addresses

Primary practice location

1001 W Seneca St
Ithaca, NY 14850-3342

Mailing address

1001 W Seneca St
Ithaca, NY 14850-3342
Phone (607) 273-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20120829000550 NY Practitioner - Physician Assistant 0840447686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1528327376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503342",
            "telephone_number": "607-273-7000",
            "fax_number": "607-273-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503342",
            "telephone_number": "607-273-7000",
            "fax_number": "607-273-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIESKA",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.