Individual provider Active NPI

Jaclyn Smith, CNM

  • Advanced Practice Midwife
  • Westwood, NJ
National Provider Identifier
1609203629
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
25ME00054101 Issued in NJ
Practice address
270 Old Hook Rd
Westwood, NJ 07675-3117
Phone
(201) 358-0505
Fax
(201) 358-1515
NPI assigned
Oct 4, 2013
Last updated
Oct 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 25ME00054101 NJ Primary
Advanced Practice Midwife 367A00000X 25ME00054100 NJ

Addresses

Primary practice location

270 Old Hook Rd
Westwood, NJ 07675-3117

Mailing address

3 Cross St
Unit 202
Suffern, NY 10901-4622
Phone (845) 596-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180629001654 NJ Practitioner - Certified Nurse Midwife (CNM) 4385990555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
25ME00054100NJMDAdvanced Practice Midwife
25ME00054101NJMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Oct 5, 2020 Accepting new patients
Lifeline Medical Associates, LLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

16 Pocono Rd
Frnt
Denville, NJ 07834
Phone (973) 784-3935

135 N Kinderkamack Rd
Montvale, NJ 07645
Phone (201) 476-0040

270 Old Hook Rd
Westwood, NJ 07675
Phone (201) 358-0505

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jaclyn.smith.1@5622.direct.athenahealth.com

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1609203629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CROSS ST",
            "address_2": "UNIT 202",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014622",
            "telephone_number": "845-596-4788",
            "fax_number": "845-357-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753117",
            "telephone_number": "201-358-0505",
            "fax_number": "201-358-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACLYN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-04",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00054101",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00054100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

Verify at the official NPI Registry.