NPIMap

Individual provider Active NPI

Mark T. Smith, M.D.

  • Nephrology Physician
  • Anchorage, AK
National Provider Identifier
1861479651
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
222405 Issued in AK
Practice address
4015 Lake Otis Pkwy Ste 201
Anchorage, AK 99508-5235
Phone
(907) 375-5200
Fax
(907) 375-5203
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 222405 AK Primary

Addresses

Primary practice location

4015 Lake Otis Pkwy Ste 201
Anchorage, AK 99508-5235

Mailing address

4015 Lake Otis Pkwy Ste 201
Anchorage, AK 99508-5235
Phone (907) 375-5200

Other identifiers 3

IdentifierTypeStateIssuer
00871109AMedicaidGA
1750606MedicaidAK
185169MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC, AK3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081007000294 GA Practitioner - NephrologyPractitioner - Internal Medicine 6305939265
I20081124000569 SC Practitioner - Nephrology 6305939265 Reassigns benefits to 1 organization
I20240528003537 AK Practitioner - Nephrology 6305939265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ohio State University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dialysis Associates of Alaska, LLCGroup PAC ID 1456345123, 13 clinicians
Kidney and Hypertension Clinic of Alaska IncGroup PAC ID 0840299186, 14 clinicians

Practice addresses (Care Compare)

3260 Providence Dr
Suite C431
Anchorage, AK 99508-4661
Phone (907) 212-4840

4015 Lake Otis Pkwy
Suite 201
Anchorage, AK 99508-5235
Phone (907) 375-5200

Hospital & facility affiliations

  • Usrc Juneau Dialysis facility, Juneau, AK, CCN 022504
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
  • Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006
  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012
  • Central Peninsula General Hospital Hospital, Soldotna, AK, CCN 020024

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222405AKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney and Hypertension Clinic of Alaska, Inc Nephrology CurrentSince May 8, 2024 Accepting new patients
Dialysis Associates of Alaska, LLC Nephrology CurrentSince May 8, 2024 Accepting new patients
Nephrology & Hypertension Associates of Alaska, PC Nephrology PastSince May 8, 2024 Accepting new patients

Locations

3260 Providence Dr
Ste C431
Anchorage, AK 99508
Phone (907) 212-4840

4015 Lake Otis Pkwy
Ste 101
Anchorage, AK 99508

3260 Providence Dr
#326
Anchorage, AK 99508
Phone (907) 562-2712

4015 Lake Otis Pkwy
Ste 201
Anchorage, AK 99508
Phone (907) 771-3500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22880/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mark.smith.1@22880.direct.athenahealth.com
  • Direct secure messaging: mark.smith.1@14795.direct.athenahealth.com

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1861479651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 LAKE OTIS PKWY STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085235",
            "telephone_number": "907-375-5200",
            "fax_number": "907-375-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 LAKE OTIS PKWY STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085235",
            "telephone_number": "907-375-5200",
            "fax_number": "907-375-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AK",
            "license": "222405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00871109A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750606",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185169",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.