Paul Yo Smithedajkul, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO3154 Issued in NV

Practice address

1701 W Charleston Blvd Ste 290
Las Vegas, NV 89102-2302

Phone

(702) 671-5127

NPI assigned

Mar 31, 2018

Sex

Male

Sole proprietor

No

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 NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Lisa a Durette MD PLLCGroup PAC ID 6103927280, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lisa a Durette MD PLLC

  dba Healthy Minds

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1669679205
  Medicare reassignment Care Compare group NPD
• Humboldt General Hospital

  • Critical Access Hospital
  • Winnemucca, NV
  • NPI 1750498010
  Medicare reassignment NPD
• Humboldt General Hospital

  • Adult Medicine Physician
  • Winnemucca, NV
  • NPI 1922152784
  Medicare reassignment NPD
• Stark Medicine Khurana Jeider PLLC

  dba Nevada Mental Health

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1053880856
  Medicare reassignment
• Humboldt General Hospital

  • Land Ambulance
  • Winnemucca, NV
  • NPI 1699899229
  NPD
• Lisa a Durette MD PLLC

  dba Healthy Minds

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1235633421

  Psychiatry

  NPD
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  NPD (past)

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1609372549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 W CHARLESTON BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891020083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 290",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022302",
            "telephone_number": "702-671-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHEDAJKUL",
        "first_name": "PAUL",
        "middle_name": "YO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-31",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "DO3154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zadok Smith
• Zahria D Smith
• Zana Lynn Smith
• Smith's Food & Drug Centers Inc (Smith's Pharmacy #315)
• Tiffinie Tee Smithe
• Lakin Smithers, ASS
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #364)
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #385)
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #377)
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #365)

• Psychiatry Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.