NPIMap

Individual provider Active NPI

Clark Samuel Smith, M.D.

  • Emergency Medicine Physician
  • Denver, CO
National Provider Identifier
1679836035
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0057191 Issued in CO
Practice address
660 Bannock St
Denver, CO 80204-4506
Phone
(303) 602-2574
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DR.0057191 CO Primary
Emergency Medicine Physician 207P00000X 2012017704 MO

Addresses

Primary practice location

660 Bannock St
Denver, CO 80204-4506

Mailing address

660 Bannock St
Denver, CO 80204-4506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804000443 CO Practitioner - Emergency Medicine 5890927289 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Community Emergency Services of Colorado Inc.Group PAC ID 2466711536, 167 clinicians

Practice addresses (Care Compare)

16320 W 64TH Ave
Arvada, CO 80007-7415
Phone (303) 925-4560

7000 E Hampden Ave
Denver, CO 80224-3012
Phone (330) 925-4199

760 Warner Dr
Golden, CO 80401-5297
Phone (303) 925-4360

Hospital & facility affiliations

  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104
  • St Anthony Summit Medical Center Hospital, Frisco, CO, CCN 060118
  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015

Merit-based Incentive Payment System (MIPS)

Final score
88.65 of 100Reported as group
Quality
86.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
91.15
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs of Colorado Inc Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine Current Accepting new patients
Premier Emergency Services, Inc Emergency Medicine CurrentSince Jun 10, 2017 Accepting new patients
Usacs of Colorado Inc Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Jul 12, 2019 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Usacs of Colorado, Inc Emergency Medicine Current Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Premier Emergency Services, Inc Emergency Medicine CurrentSince Jun 10, 2017 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. Emergency Medicine CurrentSince Jul 12, 2019 Accepting new patients

Locations

16320 W 64th Ave
Arvada, CO 80007
Phone (303) 925-4560

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

4943 State Highway 52
Ste 100
Erie, CO 80514
Phone (303) 925-4840

760 Warner Dr
Golden, CO 80401
Phone (303) 925-4360

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

3280 S Wadsworth Blvd
Lakewood, CO 80227
Phone (303) 649-3620

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

100 Health Park Dr
Louisville, CO 80027
Phone (303) 673-1000

9949 S Oswego St
Parker, CO 80134
Phone (303) 925-4700

2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280

Organizations & group practices 10

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 11

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1679836035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLARK",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0057191",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012017704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.