Individual provider Active NPI

Sara M Smith, NP

  • Family Nurse Practitioner
  • Endicott, NY
National Provider Identifier
1679981443
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338784 Issued in NY
Practice address
1302 E Main St
Endicott, NY 13760-5430
Phone
(607) 754-7171
Fax
(607) 754-0290
NPI assigned
Jul 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 338784 NY Primary

Addresses

Primary practice location

1302 E Main St
Endicott, NY 13760-5430

Mailing address

346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 754-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20141118001954 NY Practitioner - Nurse Practitioner 7315169810 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
338784NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. CurrentSince Sep 22, 2014 Accepting new patients
United Medical Associates PC CurrentSince Sep 22, 2014 Accepting new patients

Locations

91 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 648-4151

1302 E Main St
Endicott, NY 13760
Phone (607) 754-7171

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

52 Harrison St
Fl 2
Johnson City, NY 13790
Phone (607) 729-1521

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1679981443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-754-7171",
            "fax_number": "607-754-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605430",
            "telephone_number": "607-754-7171",
            "fax_number": "607-754-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SARA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

Verify at the official NPI Registry.