Michael David Smith, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

103176 Issued in FL

Practice address

40107 Highway 27
Davenport, FL 33837-5901

Phone

(863) 419-0692

Fax

(863) 419-1695

NPI assigned

Jun 30, 2006

Last updated

Apr 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 11

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, FL, WA, KY4 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 4

Specialty

Radiation Oncology

Education

Indiana University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Central Florida Cancer Institute PAGroup PAC ID 5193612778, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Logansport, IN, CCN 150072
• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: msmith134655@secure.stcharleshealthcare.org
• FHIR API: https://api.platform.athenahealth.com/20634/brand/1/csg/1/fhir/r4
• Direct secure messaging: msmith21544@direct.watsonclinicad.com

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.

• Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Celebration, FL
  • NPI 1306870092
  Medicare reassignment Care Compare group NPD
• Watson Clinic LLP

  • Internal Medicine Physician
  • Lakeland, FL
  • NPI 1316940695
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Owensboro Health Medical Group Inc

  dba Owensboro Health Muhlenberg Community Hospital Wound Center

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  Medicare reassignment NPD
• Parkview Logansport Hospital, Inc.

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1942317656
  Medicare reassignment
• Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Davenport, FL
  • NPI 1235478603
  NPD
• Baptist Health Deaconess Medical Group Inc

  • Internal Medicine Physician
  • Madisonville, KY
  • NPI 1437730942
  NPD
• Multicare Health System

  dba MultiCare Hematology/Oncology

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1376597468
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Owensboro Health Medical Group Inc

  dba Owensboro Health Medical Group Premier Primary Care

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group, Inc.

  dba Owensboro Health Cardiology

  • Specialist
  • Owensboro, KY
  • NPI 1780841361
  NPD
• Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Lake Wales, FL
  • NPI 1780923151

  Radiation Oncology

  NPD (past)

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

• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation
• Parkview Logansport Hospital Inc

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1356320469
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1902835374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CELEBRATION BLVD STE 308",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475161",
            "telephone_number": "407-599-9899",
            "fax_number": "305-946-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40107 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375901",
            "telephone_number": "863-419-0692",
            "fax_number": "863-419-1695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20405 Old Cutler Rd",
            "address_purpose": "LOCATION",
            "city": "Cutler Bay",
            "state": "FL",
            "postal_code": "331891833",
            "country_code": "US",
            "telephone_number": "305-946-1030",
            "fax_number": "305-946-1029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 SR Road 60 West",
            "address_purpose": "LOCATION",
            "city": "Lake Wales",
            "state": "FL",
            "postal_code": "338533385",
            "country_code": "US",
            "telephone_number": "863-679-2960",
            "fax_number": "863-679-2781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3699 Epworth Rd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308909",
            "country_code": "US",
            "telephone_number": "812-471-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WY",
            "license": "TL3100",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01036913A",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "H5682",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD60295642",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "021562",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "103176",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "HI",
            "license": "MD-9852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5104065",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P116158",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "1459L",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200259350",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P306917",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY KIDS THRU COMMUNITY HEALTH PARTNERS",
            "identifier": "10L838",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6067119",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01174095",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P513688",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003674000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "364004",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith21544@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karlene E Sinclair, MD
• Ulysses Singleton, DPT
• Retta Beverly Skinner
• Allistair McDonald Smith, PA
• Kristen Smith
• NA'Kirra Smith, RCSWI
• Samantha Smith, RRT
• Siobhan Maire Veronica Smith
• Beatriz Socas Montero
• Saulo Solis-Rosario

• Radiation Oncology Physician in Davenport, FL
• Providers in Davenport, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.