NPIMap

Individual provider Active NPI

Ronan H Smyth, MD

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1578619979
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34713 Issued in WI
Practice address
2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone
(920) 336-4096
Fax
(920) 336-8093
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 34713 WI
Diagnostic Radiology Physician 2085R0202X 34713 WI Primary

Addresses

Primary practice location

2941 S Ridge Rd
Green Bay, WI 54304-5517

Mailing address

2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone (920) 336-4096

Other identifiers 1

IdentifierTypeStateIssuer
31944400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsmyth4203@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031231000267 WI Practitioner - Diagnostic Radiology 6608775432 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Bay Radiology SCGroup PAC ID 7113908310, 24 clinicians
GBR Sheboygan LLCGroup PAC ID 1951341064, 22 clinicians
Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians

Practice addresses (Care Compare)

1411 N Taylor Dr
Sheboygan, WI 53081-3043
Phone (920) 457-4858

15 S 10TH St
Suite a
Oostburg, WI 53070-1370
Phone (920) 552-5046

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 498-4200

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (800) 472-6710

3113 Saemann Ave
Sheboygan, WI 53081-1957
Phone (920) 496-4700

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 846-3444

950 Woodlake Rd
Kohler, WI 53044-1348
Phone (920) 783-3150

PO Box
Suite 19070
Green Bay, WI 54307-9070

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Nicholas Hospital Hospital, Sheboygan, WI, CCN 520044
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097
  • HSHS St Clare Memorial Hospital Hospital, Oconto Falls, WI, CCN 521310
  • Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34713WIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 1, 2009 Accepting new patients
Green Bay Radiology SC Diagnostic Radiology CurrentSince Jan 1, 1984 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 1, 2009 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 1, 2008 Accepting new patients
GBR Sheboygan LLC Diagnostic Radiology CurrentSince May 1, 2005 Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 1, 2008 Accepting new patients
Fox Valley Hematology & Oncology S C PastSince Nov 1, 2017 Accepting new patients
Prevea Regional Services, Inc. Past Accepting new patients
Prevea Clinic, Inc. Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2941 S Ridge Rd
Green Bay, WI 54304
Phone (920) 336-4096

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

Interoperability endpoints

  • Direct secure messaging: rsmyth4203@ewd.direct.hshs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 13

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

View all 13

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": "1640476800000",
    "number": "1578619979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "RONAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "34713",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "34713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31944400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsmyth4203@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2941 S Ridge Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543045517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.