Eileen Pazderka Smith, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00035233 Issued in WA

Practice address

228 W Birch St
Walla Walla, WA 99362-2935

Phone

(509) 525-9404

Fax

(509) 525-9433

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mountain West Derm - Blackhart PLLC

  • Ambulatory Surgical Clinic/Center
  • Spokane Valley, WA
  • NPI 1619517539
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1558340554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W BIRCH ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622935",
            "telephone_number": "509-525-9404",
            "fax_number": "509-525-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W BIRCH ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622935",
            "telephone_number": "509-525-9404",
            "fax_number": "509-525-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EILEEN",
        "middle_name": "PAZDERKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00035233",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00035233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Small, RN
• Patrick R Smart, ARNP
• Herbert L Smeed, P.A.
• Lalani C Smiley, LICSW
• Tawn Wayne Smith-McQueen, CPSS
• Jennifer E Smith, A.R.N.P.
• Matthew Smith, PTA
• S. Scott Smith I, OD
• Lisa Smyth, LICSW
• Roland Dale Snider, MA

• Dermatology Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.