Individual provider Active NPI

Mary Beth Smarra, PA-C

  • Surgical Physician Assistant
  • Albany, GA
National Provider Identifier
1962472506
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7797 Issued in GA
Practice address
605 N Westover Blvd
Albany, GA 31707-2188
Phone
(520) 625-6600
Fax
(520) 625-8467
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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 MA003457L PA
Medical Physician Assistant 363AM0700X 3714 AZ
Surgical Physician Assistant 363AS0400X 7797 GA Primary

Addresses

Primary practice location

605 N Westover Blvd
Albany, GA 31707-2188

Mailing address

605 N Westover Blvd
Albany, GA 31707-2188
Phone (520) 625-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151123002234 GA Practitioner - Physician Assistant 7810952728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Group IncGroup PAC ID 6709878994, 12 clinicians

Practice addresses (Care Compare)

2311 Lake Park Dr
Albany, GA 31707-3183
Phone (229) 435-0525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3714AZMDPsychologist
7797GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Institute LLC CurrentSince Apr 30, 2023 Accepting new patients
Arizona Oncology Associates PC Past Accepting new patients

Locations

2311 Lake Park Dr
#4
Albany, GA 31707
Phone (229) 317-0742

2311 Lake Park Dr
Ste 4
Albany, GA 31707
Phone (229) 317-0742

2311 Lake Park Dr
Albany, GA 31707
Phone (229) 435-0525

Organizations & group practices 4

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 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1962472506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N WESTOVER BLVD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072188",
            "telephone_number": "520-625-6600",
            "fax_number": "520-625-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N WESTOVER BLVD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072188",
            "telephone_number": "520-625-6600",
            "fax_number": "520-625-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMARRA",
        "first_name": "MARY BETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003457L",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3714",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "7797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.