NPIMap

Individual provider Active NPI

Bryan David Smith, MD

  • Urology Physician
  • Pullman, WA
National Provider Identifier
1548243199
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00049274 Issued in WA
Practice address
825 SE Bishop Blvd Ste 101
Pullman, WA 99163-5517
Phone
(509) 332-3488
NPI assigned
Nov 28, 2005
Last updated
Apr 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A73728 CA
Urology Physician 208800000X MD28964 OR
Urology Physician 208800000X MD00049274 WA Primary
Urology Physician 208800000X M12316 ID

Addresses

Primary practice location

825 SE Bishop Blvd Ste 101
Pullman, WA 99163-5517

Mailing address

825 SE Bishop Blvd Ste 101
Pullman, WA 99163-5517
Phone (509) 332-3488

Other identifiers 3

IdentifierTypeStateIssuer
0238521OtherWAL & I
8519233MedicaidWA
8948199OtherWAL & I CRIME VICTIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080820000808 WA Practitioner - Urology 3274608542
I20140818002510 ID Practitioner - Urology 3274608542 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loma Linda University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gritman Medical Center IncGroup PAC ID 4981984390, 19 clinicians

Practice addresses (Care Compare)

700 S Main St
Moscow, ID 83843-3056

719 S Main St
Moscow, ID 83843-3041
Phone (208) 883-6779

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M12316IDMDUrology Physician
MD00049274WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gritman Medical Center Inc Current Accepting new patients
Gritman Medical Center Inc CurrentSince Aug 10, 2022 Accepting new patients
Gritman Medical Center Inc CurrentSince Feb 1, 2023 Accepting new patients
Gritman Medical Center Inc. CurrentSince Feb 1, 2023 Accepting new patients
Gritman Medical Center Inc CurrentSince Aug 10, 2022 Accepting new patients
Radiological Associates of Sacramento Medical Group Inc Past Accepting new patients
Gritman Medical Center, Inc. Past Accepting new patients
Gritman Medical Center Inc Urology Past Accepting new patients

Locations

700 S Main St
Moscow, ID 83843
Phone (208) 746-7555

719 S Main St
Moscow, ID 83843
Phone (208) 848-8300

803 S Main St
Ste 320
Moscow, ID 83843
Phone (208) 883-1008

Interoperability endpoints

  • Direct secure messaging: bsmith689753@direct.ochin.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1548243199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 101",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-332-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 101",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-332-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A73728",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD28964",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00049274",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M12316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0238521",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8519233",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I CRIME VICTIMS",
            "identifier": "8948199",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.