Individual provider Active NPI

Gretchen Lee Smith, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1619976149
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002171 Issued in MD
Practice address
1650 Union Ave
PBG Employee Health & Wellness Center
Baltimore, MD 21211-1917
Phone
(410) 554-7874
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002171 MD Primary

Addresses

Primary practice location

1650 Union Ave
PBG Employee Health & Wellness Center
Baltimore, MD 21211-1917

Mailing address

1650 Union Ave
PBG Employee Health & Wellness Center
Baltimore, MD 21211-1917
Phone (410) 554-7874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20250317000897 PA Practitioner - Physician Assistant 5395267694 Reassigns benefits to 1 organization
I20250317001036 MD Practitioner - Physician Assistant 5395267694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002171MDMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619976149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 UNION AVE",
            "address_2": "PBG EMPLOYEE HEALTH & WELLNESS CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111917",
            "telephone_number": "410-554-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 UNION AVE",
            "address_2": "PBG EMPLOYEE HEALTH & WELLNESS CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111917",
            "telephone_number": "410-554-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRETCHEN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.