Individual provider Active NPI

Jamie N Smith, MPH, P.A.-C

  • Physician Assistant
  • Lafayette, LA
National Provider Identifier
1790940294
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200224 Issued in LA
Practice address
3414 Moss St
Ste F
Lafayette, LA 70507-6107
Phone
(337) 706-8986
Fax
(337) 706-8714
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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 PA.200224 LA Primary

Addresses

Primary practice location

3414 Moss St
Ste F
Lafayette, LA 70507-6107

Mailing address

3414 Moss St
Ste F
Lafayette, LA 70507-6107
Phone (337) 706-8986

Other identifiers 1

IdentifierTypeStateIssuer
1882097MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090420000417 LA Practitioner - Physician Assistant 1658428172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black-Smith TrioGroup PAC ID 1759635907, 3 clinicians

Practice addresses (Care Compare)

3915 Darnall Rd
New Iberia, LA 70560-0459
Phone (337) 365-1305

Hospital & facility affiliations

  • Iberia Medical Center Hospital, New Iberia, LA, CCN 190054

Merit-based Incentive Payment System (MIPS)

Final score
80.36 of 100Reported as group
Quality
67.04
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.200224LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Acute Care Physician Services Dauterive LLC Past Accepting new patients
Capital Health Medical Group Past Accepting new patients
Premier Urgent Care Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19667/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/18065/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 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": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1790940294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 MOSS ST",
            "address_2": "STE F",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705076107",
            "telephone_number": "337-706-8986",
            "fax_number": "337-706-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 MOSS ST",
            "address_2": "STE F",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705076107",
            "telephone_number": "337-706-8986",
            "fax_number": "337-706-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMIE",
        "middle_name": "N",
        "credential": "MPH, P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882097",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.