Susanne Day Kenagy Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3933 Issued in MA

Practice address

450 Brookline Ave
Boston, MA 02215-5418

Phone

(617) 632-3861

NPI assigned

Jan 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smith.susanne.dfci@direct.partners.masshiway.net

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.

• Dana-Farber Cancer Institute, Inc.

  dba Binney Medical Associates

  • Special Hospital
  • Boston, MA
  • NPI 1346433257
  Medicare reassignment NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment NPD
• Dana-Farber Cancer Institute, Inc.

  dba The Friends' Place

  • Durable Medical Equipment & Medical Supplies
  • Chestnut Hill, MA
  • NPI 1497429237
  NPD

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1639400138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155418",
            "telephone_number": "617-632-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155418",
            "telephone_number": "617-632-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSANNE",
        "middle_name": "DAY KENAGY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3933",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "002973",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1639400138",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Elizabeth Smith, M.D.
• Sophia Marie Smith, MD
• Stacy E Smith, MD
• Stephanie Alice Smith
• Stephanie L Smith, MD
• Tanice Nicole Smith
• Taylor Smith
• Tennelle L Smith, AA,
• Timothy Neil Smith, DMD
• Timothy Richard Smith, M.D., PH.D., M.P.H.

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.