Individual provider Active NPI

Justin Matthew Smith, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1861922213
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01083575A Issued in IN
Practice address
1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239
Phone
(317) 962-3525
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11019357A IN
Emergency Medicine Physician 207P00000X 01083575A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239

Mailing address

1701 N Senate Blvd # Ag012
Indianapolis, IN 46202-1239
Phone (336) 455-3841

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200610002656 IN Practitioner - Emergency Medicine 2860760469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Brody School of Medicine at East Carolina University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Emergency Physicians IncGroup PAC ID 9931172863, 22 clinicians

Practice addresses (Care Compare)

2605 N Lebanon St
Lebanon, IN 46052-1476
Phone (765) 485-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Emergency Physicians, Inc Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1125 W Jefferson St
Franklin, IN 46131
Phone (317) 346-3858

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1861922213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD # AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "336-455-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD # AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019357A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01083575A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.