Jordan Mackenzie Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006767 Issued in OH

Practice address

262 N Main St
Monroe, OH 45050-1236

Phone

(513) 461-2273

NPI assigned

Nov 12, 2020

Sex

Male

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

Enrolled in OH, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Northern Kentucky PLLCGroup PAC ID 3779480736, 56 clinicians

Tri State Urologic Services PSC IncGroup PAC ID 6204740889, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045
• St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
• St Elizabeth Dearborn Hospital Hospital, Lawrenceburg, IN, CCN 150086
• St Elizabeth Grant Hospital, Williamstown, KY, CCN 181311

Merit-based Incentive Payment System (MIPS)

Final score

93.01 of 100Reported as apm

Quality

86.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1396938312
  Medicare reassignment Care Compare group
• Radiology Associates of Northern Kentucky, PLLC

  • Diagnostic Radiology Physician
  • Edgewood, KY
  • NPI 1073595179
  Medicare reassignment Care Compare group
• Advantage Care North America LLC

  • Urgent Care Clinic/Center
  • Monroe, OH
  • NPI 1689124513
  Medicare reassignment
• Gcga Physicians Inc.

  • Gastroenterology Physician
  • Cincinnati, OH
  • NPI 1790851095
  Medicare reassignment
• Monroe Family Medicine

  • Family Medicine Physician
  • Monroe, OH
  • NPI 1467119891
  NPD
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1699237909
  NPD
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1912729005
  NPD
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1568404846
  NPD (past)
• St Elizabeth Medical Center, Inc

  • Community/Retail Pharmacy
  • Florence, KY
  • NPI 1104699453
  NPD (past)

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

• St Elizabeth Medical Center, Inc

  • Critical Access Hospital
  • Williamstown, KY
  • NPI 1114974813
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Lawrenceburg, IN
  • NPI 1326142498
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Fort Thomas, KY
  • NPI 1740221795
  Care Compare affiliation

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1598367682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PIKE ST",
            "city": "READING",
            "state": "OH",
            "postal_code": "452153226",
            "telephone_number": "513-502-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 N MAIN ST",
            "city": "MONROE",
            "state": "OH",
            "postal_code": "450501236",
            "telephone_number": "513-461-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JORDAN",
        "middle_name": "MACKENZIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Thomas Rupert, LPCC-S, LICDC-CS
• Kayi Giselle Sanvee, RN
• Sara Care Ohio LLC
• Antwane Yul Scott
• Teresa Lyn Slone, LPN
• Pakawadee Sopapong, PT
• Southwest Ohio Surgery Center
• Richard Jason Sowers, R.N.
• Cynthia A. Spicer, LPC
• Maurice G Swanson, MD

• Physician Assistant in Monroe, OH
• Providers in Monroe, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.