Active NPI
Brandon Gregory Smith, PA-C
- Medical Physician Assistant
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA-2496
- Practice address
- 1400 E Boulder St
Suite 700
Colorado Springs, CO 80909-5533 - Phone
- (719) 635-7172
- Fax
- (719) 444-3771
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-2496 | CO | Primary |
Addresses
Primary practice location
1400 E Boulder St
Suite 700
Colorado Springs, CO 80909-5533
Mailing address
2222N Nevada Ave 4007
Colorado Springs, CO 80907-6863
Phone (719) 776-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 96130857 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2222 N Nevada Ave
Suite 4007
Colorado Springs, CO 80907-6819
Hospital & facility affiliations
- Centura Health-Penrose St Francis Health Services
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.06 of 100
- Quality
- 89.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-2496 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CS Cardiology Newco LLC | Current | Accepting new patients | |
| Pikes Peak Cardiology a Professional LLP | Past | Accepting new patients | |
| CS Cardiology Newco LLC | Past | Accepting new patients |
Locations
2222 N Nevada Ave
Ste 4007
Colorado Springs, CO 80907
Phone (719) 634-6671
904 E Hailey Ln
Ste C
Pueblo West, CO 81007
Organizations & group practices 4
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.
-
- Cardiovascular Disease Physician
- Colorado Springs, CO
- NPI 1750085445
-
- Cardiovascular Disease Physician
- Colorado Springs, CO
- NPI 1295547594
-
- Cardiovascular Disease Physician
- Canon City, CO
- NPI 1962283887
-
- Specialist
- Colorado Springs, CO
- NPI 1558363705
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1801436415
-
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1932112125
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1649479031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222N NEVADA AVE 4007",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809076863",
"telephone_number": "719-776-8500",
"fax_number": "719-634-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E BOULDER ST",
"address_2": "SUITE 700",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095533",
"telephone_number": "719-635-7172",
"fax_number": "719-444-3771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BRANDON",
"middle_name": "GREGORY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA-2496",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "96130857",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
- 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.