Individual provider Active NPI

Benjamin Smith, PA-C

  • Physician Assistant
  • Springfield, OR
National Provider Identifier
1871954750
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
188520 Issued in OR
Practice address
2280 Marcola Rd
Springfield, OR 97477-2594
Phone
(541) 747-4300
Fax
(541) 747-0655
NPI assigned
Mar 18, 2016
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-797 HI
Physician Assistant 363A00000X 188520 OR Primary
Medical Physician Assistant 363AM0700X 105989 AK

Addresses

Primary practice location

2280 Marcola Rd
Springfield, OR 97477-2594

Mailing address

2280 Marcola Rd
Springfield, OR 97477-2594
Phone (541) 747-4300

Other practice location 1

15-2662 Pahoa Village Rd # 306
Pahoa, HI 96778
Phone (808) 930-6001

Other practice location 2

1800 Centennial Blvd
Springfield, OR 97477-4379
Phone (541) 747-4300

Other identifiers 1

IdentifierTypeStateIssuer
500748366MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20180914001477 OR Practitioner - Physician Assistant 8820380090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AMD-797HIMDPhysician Assistant
188520ORMDPhysician Assistant
105989AKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Physicians, LLC Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1871954750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15-2662 Pahoa Village Rd # 306",
            "address_purpose": "LOCATION",
            "city": "Pahoa",
            "state": "HI",
            "postal_code": "96778",
            "country_code": "US",
            "telephone_number": "808-930-6001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Centennial Blvd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774379",
            "country_code": "US",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-797",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "188520",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "105989",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500748366",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.