Mark A Smith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

16959 Issued in TX

Practice address

5323 Harry Hines Blvd
Dallas, TX 75390-8095

Phone

(214) 648-3111

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mark Smith Professional name

Medicare fee-for-service enrollment

Enrolled in NE, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment Care Compare group NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  NPD (past)

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

• University of Texas Southwestern Medical Center at Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1285798918
  Care Compare affiliation

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1972675387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908095",
            "telephone_number": "214-648-3111",
            "fax_number": "402-559-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908095",
            "telephone_number": "214-648-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "PA2869",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "686",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "16959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "949901",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "SMITH",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lucy Trenary Smith, PHD
• Lynda Beth Smith, OTR/LCDC
• Marcia Jean Smith, PT
• Margaret Smith, PHD, LMFTA
• Marija Smith, LMT
• Mary Elizabeth Wilcox Smith, M.D.
• Mary M Smith, L.P.C.
• Mary Magdalene Smith, M.A.
• Mary Rochelle Smith, MD
• Matthew Gregory Smith, DDS

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.