Active NPI
Pamela J Smith, MD
- Emergency Medicine Physician
- Newburyport, MA
National Provider Identifier
1720031925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 160859
- Practice address
- 25 Highland Ave
Newburyport, MA 01950-3867 - Phone
- (978) 463-1050
- NPI assigned
- May 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 40008 | CO | |
| Emergency Medicine Physician | 207P00000X | 160859 | MA | Primary |
Addresses
Primary practice location
25 Highland Ave
Newburyport, MA 01950-3867
Mailing address
12 Gill St
Woburn, MA 01801-1728
Phone (781) 937-4522
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J21316 | Other | MA | BCBS OF MA |
| 3198758 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40008 | CO | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Inpatient Medical Associates Inc. | Past | Accepting new patients | |
| VVMC Diversified Services | Past | Accepting new patients | |
| Vail Clinic, Inc. | Past | Accepting new patients |
Interoperability endpoints
- psmith31718@tuftsmedicine.direct-ci.com
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.
-
dba Trinity Health Of New England Medical Group
- Internal Medicine Physician
- Springfield, MA
- NPI 1407845282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1720031925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 GILL ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011728",
"telephone_number": "781-937-4522",
"fax_number": "781-937-4510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HIGHLAND AVE",
"city": "NEWBURYPORT",
"state": "MA",
"postal_code": "019503867",
"telephone_number": "978-463-1050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PAMELA",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "40008",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "160859",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MA",
"identifier": "J21316",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3198758",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburyport, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.