MR. JASON ROBERT SMITH PA-C NPI 1689759862

NPI Information

NPI: 1689759862
Provider Name: MR. JASON ROBERT SMITH, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA
ZIP 19104
Phone: (267) 426-5546
Get Directions

MR. Jason Robert Smith, PA-C is a surgical physician assistant in Philadelphia, PA. MR. Jason Robert Smith, PA-C NPI is 1689759862. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3401 CIVIC CENTER BLVD
PHILADELPHIA, PA
ZIP 19104-319
Phone: (267) 426-5546
Fax: (215) 386-4036

The enumeration date for this NPI number is 10/26/2006 and was last updated on 9/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		C5-0000717	DELAWARE	No
2	363A00000X	Physician Assistant		C50000717	DELAWARE	No
3	363AS0400X	Physician Assistant	Surgical	25MP00161900	NEW JERSEY	No
4	363AS0400X	Physician Assistant	Surgical	MA052891	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	25MP00161900	OTHER	NEW JERSEY	NJ LICENSE
2	Q74729	MEDICARE UPIN
3	MA052891	OTHER	PENNSYLVANIA	PENNSYLANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
4	C5-0000717	OTHER	DELAWARE	DELAWARE DIVISION OF PROFESSIONAL REGULATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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