Nicholas David Woloszyn Smith, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY11240 Issued in FL

Practice address

501 6TH St S
St Petersburg, FL 33701-4630

Phone

(727) 767-7451

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  Medicare reassignment NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD
• University Medical Service Association Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1326088295
  NPD

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1861147324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2937 WINGLEWOOD CIR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585036",
            "telephone_number": "724-599-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014630",
            "telephone_number": "727-767-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS DAVID",
        "middle_name": "WOLOSZYN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "MYDVF",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113855800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsmith246576@direct.tgh.org",
            "affiliation": "N",
            "address_1": "501 6th St S",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337014630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Ann Smith, AP
• Meleah Jacqueline Smith, LCSW
• Michael J Smith, MD
• Michelle Marie Smith, M.D.
• Morgan Candler Smith, MD
• Nichole Marie Smith
• Nicole Smith, LCSW
• Niki Dee Ann Smith
• Patrick Judson Smith, MD
• Paul Ronald Smith, O.D.

• Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.