Tonya Lanett Smith, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19549 Issued in CA

Practice address

1552 Coffee Rd Ste 200
Modesto, CA 95355-3122

Phone

(209) 248-7168

Fax

(209) 846-9641

NPI assigned

Jan 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

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.

• Central California Bariatric Surgery a Medical Corporation

  • Surgery Physician
  • Modesto, CA
  • NPI 1124141163
  Medicare reassignment

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992983001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1750",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953361153",
            "telephone_number": "209-665-8566",
            "fax_number": "209-846-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553122",
            "telephone_number": "209-248-7168",
            "fax_number": "209-846-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TONYA",
        "middle_name": "LANETT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Smith
• Tamlyn Shaday Smith
• Tanya Sue Smith
• Tiffany Smith
• Todd C Smith, M.D.
• Victoria Smith
• Violet Marie Smith
• William Richard Smith, MD
• Zacharia Smith
• Raymond Scott Smyth

• Medical Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.