Laura T Smutz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA059617 Issued in PA

Practice address

577 Third Ave
Chula Vista, CA 91910-5619

Phone

(858) 909-0770

NPI assigned

Nov 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Laura J Tiernan Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ritvik Mehta, MD Apc

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  • Carlsbad, CA
  • NPI 1538302997
  NPD

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1558875013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 GRANADA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 THIRD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105619",
            "telephone_number": "858-909-0770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 South Front Street",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171041619",
            "country_code": "US",
            "telephone_number": "717-231-8555",
            "fax_number": "717-231-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMUTZ",
        "first_name": "LAURA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "1143086",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103446545",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsmutz64129@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "205 South Front Street",
            "address_2": "4th Floor",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171041619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "TIERNAN",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Tierney Houck Smith
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• Physician Assistant in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.