Individual provider Active NPI

Melanie Smith, AGACNP

  • Gerontology Nurse Practitioner
  • Seguin, TX
National Provider Identifier
1669102208
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1084536 Issued in TX
Practice address
1215 E Court St
Seguin, TX 78155-5129
Phone
(830) 379-2411
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1084536 TX
Gerontology Nurse Practitioner 363LG0600X 1084536 TX Primary

Addresses

Primary practice location

1215 E Court St
Seguin, TX 78155-5129

Mailing address

1215 E Court St
Seguin, TX 78155-5129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220916002598 TX Practitioner - Nurse Practitioner 2365827912

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guadalupe County Hospital BoardGroup PAC ID 5496653842, shared by 29 NPIs, 31 clinicians

Practice addresses (Care Compare)

1215 E Court
HBP Cardiology Group
Seguin, TX 78155-5129
Phone (830) 379-2411

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 379-2411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as group
Quality
67.88
Promoting interoperability
87
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1084536TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Kidney Disease Center Physicians Group, P.L.L.C. PastSince Jul 18, 2022 Accepting new patients

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.

Hospital & facility affiliations 4

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1669102208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-379-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELANIE",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1084536",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1084536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.