Individual provider Active NPI

Faye M. Smith-Chakmakova, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • South Lake Tahoe, CA
National Provider Identifier
1831411933
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
C165898 Issued in CA
Practice address
2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone
(530) 541-3420
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X C165898 CA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD447815 PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R71376 AZ

Addresses

Primary practice location

2170 South Ave
South Lake Tahoe, CA 96150-7026

Mailing address

4TH and Walnut
Lebanon, PA 17042-1281
Phone (717) 720-7551

Other identifiers 3

IdentifierTypeStateIssuer
R71376OtherAZTRAINING PERMIT
P01392613OtherPARAILROAD MEDICARE
102944900MedicaidPA

Other names 1

  • Faye Marie Smith Former name

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200123001200 CA Practitioner - Pathology 3375761539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5807

Hospital & facility affiliations

  • Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352
  • Carson Valley Health Hospital, Gardnerville, NV, CCN 291306
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R71376AZMDAnatomic Pathology & Clinical Pathology Physician
C165898CAMDAnatomic Pathology & Clinical Pathology Physician
MD447815PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Carson Valley Medical Group Inc CurrentSince Jan 1, 2020 Accepting new patients
Barton Healthcare System Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2020 Accepting new patients
Barton Healthcare System CurrentSince Jan 1, 2020 Accepting new patients
Barton Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients

Locations

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

Organizations & group practices 4

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 7

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": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1831411933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4TH AND WALNUT",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170421281",
            "telephone_number": "717-720-7551",
            "fax_number": "717-272-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-CHAKMAKOVA",
        "first_name": "FAYE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C165898",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD447815",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R71376",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R71376",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01392613",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102944900",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAYE",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.