Individual provider Active NPI

Mitchell T Smith, MD

  • Vascular & Interventional Radiology Physician
  • Denver, CO
National Provider Identifier
1538215215
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
DR.0046489 Issued in CO
Practice address
2045 N Franklin St
Denver, CO 80205-5437
Phone
(303) 338-4545
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 46489 CO
Vascular & Interventional Radiology Physician 2085R0204X DR.0046489 CO Primary

Addresses

Primary practice location

2045 N Franklin St
Denver, CO 80205-5437

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 2

IdentifierTypeStateIssuer
60702737MedicaidCO
028944OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20090826000443 CO Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5799830857 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Tulane University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Hospital, IncGroup PAC ID 6204735970, 18 clinicians
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

1375 E 19TH Ave
Denver, CO 80218-1114
Phone (303) 812-2000

2045 N Franklin St
Kaiser Permanente Franklin Medical
Denver, CO 80205-5437
Phone (303) 338-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46489COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Medical Center, LLC CurrentSince Jan 7, 2019 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jan 8, 2016 Accepting new patients
Colorado Permanente Medical Group, P.C. Diagnostic Radiology CurrentSince Jan 7, 2019 Accepting new patients
Good Samaritan Medical Center, LLC CurrentSince Jan 7, 2019 Accepting new patients
Saint Joseph Hospital, Inc CurrentSince Jan 7, 2019 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jan 8, 2016 Accepting new patients
Saint Joseph Hospital, Inc CurrentSince Jan 7, 2019 Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1375 E 19th Ave
Denver, CO 80218
Phone (303) 812-2000

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

777 Bannock St
Denver, CO 80204

200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16660/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1538215215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 N FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MITCHELL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "46489",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "DR.0046489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60702737",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "028944",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2045 N Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.