NPIMap

Individual provider Active NPI

Stafford Michael Smith, M.D.

  • Interventional Cardiology Physician
  • Clarks Green, PA
National Provider Identifier
1710913736
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD040434L Issued in PA
Practice address
102 N Abington Rd
Suite #103
Clarks Green, PA 18411-2300
Phone
(570) 586-0246
Fax
(570) 585-8970
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD040434L PA Primary

Addresses

Primary practice location

102 N Abington Rd
Suite #103
Clarks Green, PA 18411-2300

Mailing address

102 N Abington Rd
Suite #103
Clarks Green, PA 18411-2300
Phone (570) 586-0246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040105000101 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional CardiologyPractitioner - Internal Medicine 2163321654 Reassigns benefits to 2 organizations
I20151120001373 FL Practitioner - Interventional Cardiology 2163321654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 N Abington Rd
Suite 103
Clarks Green, PA 18411-2326
Phone (570) 586-0246

5136 Far Oak Cir
Sarasota, FL 34238-3303
Phone (570) 903-1389

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital CurrentSince Jul 1, 2025 Accepting new patients
Wayne Memorial Hospital Interventional Cardiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

102 N Abington Rd
Ste 103
Clarks Green, PA 18411
Phone (570) 586-0246

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710913736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N ABINGTON RD",
            "address_2": "SUITE #103",
            "city": "CLARKS GREEN",
            "state": "PA",
            "postal_code": "184112300",
            "telephone_number": "570-586-0246",
            "fax_number": "570-585-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N ABINGTON RD",
            "address_2": "SUITE #103",
            "city": "CLARKS GREEN",
            "state": "PA",
            "postal_code": "184112300",
            "telephone_number": "570-586-0246",
            "fax_number": "570-585-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STAFFORD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD040434L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Green, PA

Sources for this page

Verify at the official NPI Registry.