Individual provider Active NPI

Dinos Justin Smith, DO

  • Anesthesiology Physician
  • Hollywood, FL
National Provider Identifier
1720320864
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34.013724 Issued in OH
Practice address
300 S Park Rd
Suite 400
Hollywood, FL 33021-8593
Phone
(800) 815-8377
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 34.013724 OH Primary

Addresses

Primary practice location

300 S Park Rd
Suite 400
Hollywood, FL 33021-8593

Mailing address

293 Bailey Rd
Lewisburg, WV 24901-9445
Phone (304) 923-5904

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsmith196782@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190521000608 OH Practitioner - Anesthesiology 5698919744 Reassigns benefits to 1 organization
I20200730003262 WV Practitioner - Anesthesiology 5698919744 Reassigns benefits to 2 organizations
I20210630001566 NC Practitioner - Anesthesiology 5698919744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Cities Anesthesia PLLCGroup PAC ID 6002707015, 60 clinicians

Practice addresses (Care Compare)

2900 1St Ave
Huntington, WV 25702-1241
Phone (304) 736-6126

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1736WVMDProfessional Counselor
34.013724OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of West Virginia, PLLC Single Specialty CurrentSince Feb 13, 2023 Accepting new patients
Western Piedmont Anesthesia PA Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
River Cities Anesthesia PLLC Single Specialty CurrentSince Dec 1, 2021 Accepting new patients
WV Emergency Physician Partners PLLC Single Specialty Past Accepting new patients

Locations

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

5897 County Road 107
Proctorville, OH 45669
Phone (304) 399-2222

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

Organizations & group practices 4

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 1

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1720320864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 BAILEY RD",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019445",
            "telephone_number": "304-923-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PARK RD",
            "address_2": "SUITE 400",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218593",
            "telephone_number": "800-815-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DINOS",
        "middle_name": "JUSTIN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.013724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsmith196782@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "327 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.