Active NPI
Heather Smith
- Physician Assistant
- Crystal, MN
National Provider Identifier
1992038236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1332
- Practice address
- 4725 36TH Ave N
Crystal, MN 55422-2169 - Phone
- (763) 231-8700
- Fax
- (763) 231-8711
- NPI assigned
- Sep 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1332 | MN | Primary |
Addresses
Primary practice location
4725 36TH Ave N
Crystal, MN 55422-2169
Mailing address
4725 36TH Ave N
Crystal, MN 55422-2169
Phone (763) 231-8700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1414 Woodland Ave
Duluth, MN 55803-2624
Phone (218) 302-1000
Hospital & facility affiliations
- St Lukes Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1332 | MN | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Physician Assistant
- Duluth, MN
- NPI 1316348725
Hospital & facility affiliations 26
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Duluth, MN
- NPI 1093769796
Hospital
-
- Vascular & Interventional Radiology Physician
- Duluth, MN
- NPI 1124732110
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1992038236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4725 36TH AVE N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554222169",
"telephone_number": "763-231-8700",
"fax_number": "763-231-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 36TH AVE N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554222169",
"telephone_number": "763-231-8700",
"fax_number": "763-231-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-17",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "1332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.