Organization Active NPI

Chester L Smith Jr MD PC

  • Obstetrics & Gynecology Physician
  • East Stroudsburg, PA
National Provider Identifier
1720626310
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CHESTER L SMITH JR MD PC
Practice address
369 E Brown St
East Stroudsburg, PA 18301-9101
Phone
(570) 421-6730
NPI assigned
Dec 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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

Authorized official

Name
Donna Casper
Title
Credentialing Account Manager
Phone
(904) 416-1021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

369 E Brown St
East Stroudsburg, PA 18301-9101

Mailing address

369 E Brown St
East Stroudsburg, PA 18301-9101
Phone (570) 421-6730

Other names 1

  • Chester L Smith MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200330000040 PA Part B Supplier - Clinic/Group Practice 0749619690 Receives reassigned benefits from 1 practitioner
Practice locations: East Stroudsburg, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2112148Chester L Smith Jr MD PC369 East Brown Street, East Stroudsburg, PA 18301Certificate of waiverApr 22, 2028

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20255/brand/1/csg/1/fhir/r4

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": "1576368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576368000000",
    "number": "1720626310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019101",
            "telephone_number": "570-421-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019101",
            "telephone_number": "570-421-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTER L SMITH JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A",
        "authorized_official_last_name": "CASPER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CREDENTIALING ACCOUNT MANAGER",
        "authorized_official_telephone_number": "904-416-1021"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chester L Smith MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.