Active NPI
Stephen Michael Smith, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- New Haven, CT
National Provider Identifier
1669714788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 56330
- Practice address
- 20 York St
Yale New Haven Hospital
New Haven, CT 06510 - Phone
- (203) 737-4142
- NPI assigned
- Mar 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 56330 | CT | Primary |
Addresses
Primary practice location
20 York St
Yale New Haven Hospital
New Haven, CT 06510
Mailing address
310 Cedar Street
New Haven, CT 06520-8070
Phone (203) 737-4142
Other practice location 1
410 W 10th Ave
N-308 Doan Hall
Columbus, OH 43210-1240
Phone (419) 322-1871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130906000854 | OH | Order and Referring Only - Pathology | 6406099647 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56330 | CT | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1669714788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 CEDAR STREET",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065208070",
"telephone_number": "203-737-4142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST",
"address_2": "YALE NEW HAVEN HOSPITAL",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "203-737-4142"
}
],
"practiceLocations": [
{
"address_1": "410 W 10th Ave",
"address_2": "N-308 Doan Hall",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432101240",
"country_code": "US",
"telephone_number": "419-322-1871",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "STEPHEN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CT",
"license": "56330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.