Individual provider Active NPI

Elizabeth Smith, M.D.

  • Pediatrics Physician
  • North Dartmouth, MA
National Provider Identifier
1609895051
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
277083 Issued in MA
Practice address
49 State Road
Nauset BLDG, Suite 202
North Dartmouth, MA 02747
Phone
(089) 739-2405
NPI assigned
Jul 18, 2006
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 277083 MA Primary

Addresses

Primary practice location

49 State Road
Nauset BLDG, Suite 202
North Dartmouth, MA 02747

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other names 1

  • Elizabeth Ann Roche Smith Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address esmith43327@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20201119000157 MA Practitioner - Pediatric Medicine 4486669603 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5742MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ithaca Medical Services PLLC Current Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Cma Medical Practice PLLC Current Accepting new patients
CH DHC Inc Pediatrics Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

49 State Rd
North Dartmouth, MA 02747
Phone (508) 973-9240

49 State Rd
Ste 202
North Dartmouth, MA 02747
Phone (508) 973-9240

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1609895051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 STATE ROAD",
            "address_2": "NAUSET BLDG, SUITE 202",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "089-739-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "277083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "esmith43327@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "49 State Road",
            "address_2": "Nauset Bldg, Suite 202",
            "city": "North Dartmouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SMITH",
            "middle_name": "ANN ROCHE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.