Individual provider Active NPI

Matthew Wayne Smith, D.O.

  • Emergency Medicine Physician
  • Tarpon Springs, FL
National Provider Identifier
1891155339
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS16446 Issued in FL
Practice address
1395 S Pinellas Ave FL 34689
Tarpon Springs, FL 34689-3790
Phone
(727) 942-5000
NPI assigned
Feb 25, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X OS16446 FL Primary

Addresses

Primary practice location

1395 S Pinellas Ave FL 34689
Tarpon Springs, FL 34689-3790

Mailing address

4474 Rockwood Dr
Palm Harbor, FL 34685-3678
Phone (580) 399-9255

Other practice location 1

1500 W El Paso St
Broken Arrow, OK 74012-8345
Phone (580) 399-9255

Other practice location 2

744 W 9th St
Tulsa, OK 74127-9907
Phone (918) 599-5373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170828000826 OK Practitioner - Emergency Medicine 0840562773 Reassigns benefits to 1 organization
I20200506000536 FL Practitioner - Emergency Medicine 0840562773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
83.29
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.65 of 100Reported as group
Quality
90.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6257OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians LLC Single Specialty CurrentSince Apr 28, 2020 Accepting new patients
Tampa Bay Emergency Physicians-Heartland LLC Single Specialty CurrentSince Apr 1, 2024 Accepting new patients

Locations

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

Organizations & group practices 3

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1891155339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4474 ROCKWOOD DR",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346853678",
            "telephone_number": "580-399-9255",
            "fax_number": "844-209-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 S PINELLAS AVE FL 34689",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346893790",
            "telephone_number": "727-942-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W El Paso St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740128345",
            "country_code": "US",
            "telephone_number": "580-399-9255",
            "fax_number": "844-209-9064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741279907",
            "country_code": "US",
            "telephone_number": "918-599-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS16446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

Verify at the official NPI Registry.