Individual provider Active NPI

Colleen Michelle Smith, MD

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790051076
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
278552 Issued in NY
Practice address
4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219-2916
Phone
(718) 283-6000
NPI assigned
Mar 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 278552 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160209002196 NY Practitioner - Emergency Medicine 8729382940 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278552NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Mar 11, 2024 Accepting new patients
Maimonides Medical Center Current Accepting new patients
New York University Emergency Medicine CurrentSince Dec 9, 2015 Accepting new patients
The Unity Hospital of Rochester CurrentSince Mar 11, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Feb 24, 2018 Accepting new patients
Rochester General Hospital Current Accepting new patients
Newark Wayne Community Hospital CurrentSince Mar 11, 2024 Accepting new patients
Rochester General Hospital CurrentSince Mar 11, 2024 Accepting new patients
Rochester General Hospital CurrentSince Mar 11, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Newark Wayne Community Hospital CurrentSince Mar 11, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 24, 2018 Accepting new patients
New York University CurrentSince Dec 9, 2015 Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Emergency Medicine CurrentSince Mar 21, 2020 Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: colleensmith@mai.allscriptsdirect.net
  • Direct secure messaging: csmith261084@nychhc.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1790051076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COLLEEN",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "278552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.