Individual provider Active NPI

Howard Smith, PA

  • Physician Assistant
  • Gasport, NY
National Provider Identifier
1881659811
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011027 Issued in NY
Practice address
7914 Chestnut Ridge Rd
Gasport, NY 14067-9277
Phone
(716) 772-2804
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011027 NY Primary

Addresses

Primary practice location

7914 Chestnut Ridge Rd
Gasport, NY 14067-9277

Mailing address

7914 Chestnut Ridge Rd
Gasport, NY 14067-9277
Phone (716) 772-2804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071009000069 NY Practitioner - Physician Assistant 0143315960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011027NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks-TLC Hospital System, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Brooks - TLC Hospital System, Inc. CurrentSince Mar 1, 2019 Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1881659811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7914 CHESTNUT RIDGE RD",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679277",
            "telephone_number": "716-772-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7914 CHESTNUT RIDGE RD",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679277",
            "telephone_number": "716-772-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HOWARD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gasport, NY

Sources for this page

Verify at the official NPI Registry.