Micheal Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

8110 Timberlake Way
Sacramento, CA 95823-5401

Phone

(916) 688-5837

Fax

(916) 689-6620

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.smith.p1@direct.peachtreehealth.nextgenshare.com

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.

• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622
  Medicare reassignment
• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1245043413
  NPD
• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Live Oak, CA
  • NPI 1316096894
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1811945629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 TIMBERLAKE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235401",
            "telephone_number": "916-688-5837",
            "fax_number": "916-689-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 TIMBERLAKE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235401",
            "telephone_number": "916-688-5837",
            "fax_number": "916-689-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHEAL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "14393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlon Scott Smith, D.D.S.
• Mary Patricia Smith
• Mauresha Denaye' Smith
• Maya Jazmin Smith, MD
• Melissa Kay Smith, D.P.T, A.T.C.
• Michele Lynn Pettit Smith, RN
• Michelle Smith, REVEREND
• Miguel Smith
• Monica Smith
• Monika Letitia Smith

• Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.