Timothy R. Smith, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00687 Issued in OR

Practice address

3288 Moanalua Rd
Honolulu, HI 96819-1469

Phone

(808) 432-0000

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

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

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment Care Compare group

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

• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1396813861
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1962583302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3288 Moanalua Rd",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968191469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick A Smith
• Roxanne Allison Smith, MD
• Sarah Price Smith, PT, DPT
• Stephen Michael Smith, M.D.
• Sydney George Smith, M.D.
• Tracey Smith
• Traci Smith, PHARMD
• Zachary Floyd Smith
• Shannon Smoke, DPT
• Heidi Barbara Park Smoot, LMFT

• Physician Assistant in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.