Individual provider Active NPI

Charles Giles Smith III, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1659633097
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301100992 Issued in MI
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(888) 362-2500
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301100992 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St
Detroit, MI 48201-2153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171004001897 MI Practitioner - Pain ManagementPractitioner - Anesthesiology 4385945518 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Wayne State University School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (214) 687-0001

Hospital & facility affiliations

  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100992MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pain Clinic Associates, PLLC CurrentSince Aug 29, 2017 Accepting new patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Nov 20, 2017 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Aug 29, 2023 Accepting new patients

Locations

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

4160 John R St
Ste 522
Detroit, MI 48201
Phone (313) 745-1293

4100 John R St
#A
Detroit, MI 48201

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: csmithc7815@direct.dmc.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1659633097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "888-362-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "GILES",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301100992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.