Active NPI
Steven Smedman, CASAC-T
- Prevention Professional
- Bronx, NY
National Provider Identifier
1801620166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 39685
- Practice address
- 770 E 176TH St
Bronx, NY 10460-4617 - Phone
- (718) 583-5150
- NPI assigned
- Aug 29, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 39685 | NY | Primary |
Addresses
Primary practice location
770 E 176TH St
Bronx, NY 10460-4617
Mailing address
770 E 176TH St
Bronx, NY 10460-4617
Phone (718) 583-5150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39685 | NY | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1801620166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 E 176TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104604617",
"telephone_number": "718-583-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 E 176TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104604617",
"telephone_number": "718-583-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMEDMAN",
"first_name": "STEVEN",
"credential": "CASAC-T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-29",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NY",
"license": "39685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.