NPIMap

Organization Active NPI

SMH Physician Services Inc

  • Pain Medicine (Anesthesiology) Physician
  • Bradenton, FL
National Provider Identifier
1699189449
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME111784 Issued in FL
Legal business name
SMH PHYSICIAN SERVICES INC
Practice address
1040 River Heritage Blvd
Suite 201
Bradenton, FL 34212-6348
Phone
(941) 917-4500
Fax
(941) 917-4507
NPI assigned
Jun 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Ilene Gilbert, COO
Title
Coo
Phone
(941) 917-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X ME111784 FL Primary

Addresses

Primary practice location

1040 River Heritage Blvd
Suite 201
Bradenton, FL 34212-6348

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other identifiers 2

IdentifierTypeStateIssuer
376537700MedicaidFL
33181OtherFLBCBS

Other names 1

  • Pain Mgmt at Heritage Harbor Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000211 FL Part B Supplier - Clinic/Group Practice 1355240177 Receives reassigned benefits from 1,046 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sarasota, FL; Venice, FL; Osprey, FL; Lakewood Ranch, FL; North Port, FL; Bradenton, FL; North Venice, FL

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1699189449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER HERITAGE BLVD",
            "address_2": "SUITE 201",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342126348",
            "telephone_number": "941-917-4500",
            "fax_number": "941-917-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "ILENE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "941-917-8720",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME111784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376537700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "33181",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Mgmt at Heritage Harbor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.