Individual provider Active NPI

Smita Carroll, MD, MBA, MPH

  • Obstetrics & Gynecology Physician
  • Hackensack, NJ
National Provider Identifier
1699207662
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA12595900 Issued in NJ
Practice address
20 Prospect Ave
Ste 607
Hackensack, NJ 07601-1962
Phone
(551) 996-8400
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 321357-01 NY
Complex Family Planning Physician 207VC0300X 321357-01 NY
Obstetrics & Gynecology Physician 207V00000X 25MA12595900 NJ Primary

Addresses

Primary practice location

20 Prospect Ave
Ste 607
Hackensack, NJ 07601-1962

Mailing address

331 Newman Springs Rd
BLDG 2, Ste 220
Red Bank, NJ 07701-5688

Other practice location 1

100 E 77th St
New York, NY 10075-1850
Phone (212) 434-2000

Other practice location 2

2211 Lomas Blvd NE
Albuquerque, NM 87131-2903
Phone (505) 272-0776

Other practice location 3

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Other names 1

  • Smita Ravichandran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231220001688 NY Practitioner - Obstetrics/Gynecology 9234402702 Reassigns benefits to 1 organization
I20250509002975 NJ Practitioner - Obstetrics/Gynecology 9234402702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

20 Prospect Ave
Suite 607
Hackensack, NJ 07601-1962
Phone (551) 996-1235

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
321357-01NYMDComplex Family Planning Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 7, 2025 Accepting new patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince Oct 28, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 7, 2025 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Obstetrics & Gynecology Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

20 Prospect Ave
Ste 607
Hackensack, NJ 07601
Phone (201) 487-3464

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: smitacarroll@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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 2

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1699207662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "STE 607",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011962",
            "telephone_number": "551-996-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E 77th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751850",
            "country_code": "US",
            "telephone_number": "212-434-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871312903",
            "country_code": "US",
            "telephone_number": "505-272-0776",
            "fax_number": "505-272-6385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "SMITA",
        "credential": "MD, MBA, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "321357-01",
            "primary": false
        },
        {
            "code": "207VC0300X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Complex Family Planning",
            "state": "NY",
            "license": "321357-01",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA12595900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SMITA",
            "last_name": "RAVICHANDRAN",
            "credential": "MD, MBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.