Individual provider Active NPI

Jolene M Smith, DO

  • Pain Medicine (Anesthesiology) Physician
  • Clive, IA
National Provider Identifier
1629399373
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
DO-04738 Issued in IA
Practice address
12499 University Ave Ste 280
Clive, IA 50325-8288
Phone
(515) 245-6425
NPI assigned
Jun 17, 2010
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 54268 MN
Anesthesiology Physician 207L00000X DO-04738 IA
Pain Medicine (Anesthesiology) Physician 207LP2900X 54268 MN
Pain Medicine (Anesthesiology) Physician 207LP2900X DO-04738 IA Primary

Addresses

Primary practice location

12499 University Ave Ste 280
Clive, IA 50325-8288

Mailing address

300 Abigail LN
Waukee, IA 50263-8746
Phone (612) 239-8673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20150710000143 IA Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Pain Management 9739353764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Pain Management
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12499 University Ave
Suite 100
Clive, IA 50325-8288
Phone (515) 245-6425

1601 60TH St
West Des Moines, IA 50266-7736
Phone (515) 358-8000

204 N 4TH Ave E
Newton, IA 50208-3135
Phone (641) 791-4336

411 Laurel St
Suite 1100
Des Moines, IA 50314-3005
Phone (515) 643-8650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.35 of 100Reported as group
Quality
60.03
Improvement activities
40
Cost
64.44

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-04738IAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesiologists, P.C. Anesthesiology CurrentSince Jul 6, 2015 Accepting new patients
Medical Center Anesthesiologists, P.C. CurrentSince Jul 6, 2015 Accepting new patients

Locations

1111 6th Ave
Fl 3
Des Moines, IA 50314

411 Laurel St
Ste 3170
Des Moines, IA 50314
Phone (515) 283-0463

204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800

1225 Jordan Creek Pkwy
Ste 180
West Des Moines, IA 50266
Phone (515) 283-0463

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

Interoperability endpoints

  • Direct secure messaging: jolene.smith@mcap.eclinicaldirectplus.com
  • Direct secure messaging: jsmith3963859@direct.trinity-health.org

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 6

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1629399373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ABIGAIL LN",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502638746",
            "telephone_number": "612-239-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE STE 280",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-245-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOLENE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "54268",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "DO-04738",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MN",
            "license": "54268",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IA",
            "license": "DO-04738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.