Individual provider Active NPI

Bradford Davison Smith Jr., M.D.

  • Otolaryngology Physician
  • Wynnewood, PA
National Provider Identifier
1811924830
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD029553E Issued in PA
Practice address
100 E Lancaster Ave
Suite 650 Mob East
Wynnewood, PA 19096-3437
Phone
(610) 896-6800
Fax
(610) 896-5627
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD029553E PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 650 Mob East
Wynnewood, PA 19096-3437

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101101000934 PA Practitioner - Otolaryngology 2567562218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Pittsburgh School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-6421

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
William J Lewis MD PC Otolaryngology CurrentSince Jul 17, 1987 Accepting new patients
Main Line Healthcare CurrentSince Jan 30, 2025 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

100 E Lancaster Ave
Ste 650
Wynnewood, PA 19096
Phone (610) 649-8055

650 Lankenau Medical Building E
Wynnewood, PA 19096
Phone (610) 896-6800

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

100 E Lancaster Ave
#33
Wynnewood, PA 19096
Phone (610) 896-6800

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1811924830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 650 MOB EAST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963437",
            "telephone_number": "610-896-6800",
            "fax_number": "610-896-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADFORD",
        "middle_name": "DAVISON",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-02-19",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD029553E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.