Individual provider Active NPI

Mark Patrick Smyly, PA-C

  • Physician Assistant
  • Post Falls, ID
National Provider Identifier
1750939302
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1593 E Polston Ave
Post Falls, ID 83854-5326
Phone
(208) 262-2300
Fax
(208) 262-2390
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1593 E Polston Ave
Post Falls, ID 83854-5326

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 664-2175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415001181 ID Practitioner - Physician Assistant 8022426808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Surgery and SportsGroup PAC ID 3375519168, 28 clinicians
North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

1160 E Polston Ave
Suite B
Post Falls, ID 83854-6045
Phone (208) 262-0156

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

750 N Syringa St
Post Falls, ID 83854-5275

850 W Ironwood Dr
Suite 202
Coeur D Alene, ID 83814-4903
Phone (208) 664-2175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Surgery and Sports Physician Assistant CurrentSince Oct 2, 2023 Accepting new patients

Locations

850 W Ironwood Dr
Ste 202
Coeur D Alene, ID 83814
Phone (208) 601-6038

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

1160 E Polston Ave
#B
Post Falls, ID 83854
Phone (208) 262-0156

Interoperability endpoints

  • Direct secure messaging: msmyly@ossmidaho.emadirect.md

Organizations & group practices 2

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 4

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1750939302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-664-2175",
            "fax_number": "208-664-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLY",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.