ROOSEVELT SMITH JR. PAC, ATR
NPI 1003836701
Physician Assistant - Medical in Winona, MN
About Roosevelt Smith Jr. Pac, Atr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROOSEVELT SMITH JR. PAC, ATR (NPI 1003836701) is an individual medical provider in Winona, Minnesota, licensed in Minnesota (9155) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Winona Health Services, and is a graduate of Other (1981).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Roosevelt Smith Jr. Pac, Atr is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Winona Health Services
Acute Care Hospitals · Winona, MNOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Roosevelt Smith's NPI number?
The NPI number for Roosevelt Smith is 1003836701. It was assigned to this individual provider in the NPPES registry on July 19, 2006.
Where is Roosevelt Smith located?
Roosevelt Smith practices at 62 E 3rd St Suite 3, Winona, MN 55987. The listed phone number is (507) 474-4770.
What is Roosevelt Smith's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Roosevelt Smith enrolled in Medicare?
Yes. Roosevelt Smith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Roosevelt Smith affiliated with any hospitals?
According to CMS data, Roosevelt Smith is affiliated with Winona Health Services.
When was this NPI record last updated?
The NPPES record for Roosevelt Smith was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Roosevelt Smith Jr., PAC, ATR · NPI 1003836701
Medical physician in Winona, Minnesota. Individual provider, active in the CMS NPPES registry since July 19, 2006.
## Identity
- **NPI:** 1003836701 (Entity type: Individual)
- **Enumerated:** July 19, 2006
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 9155 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 62 E 3RD ST, SUITE 3, Winona, MN 55987-3481
- **Phone:** (507) 474-4770 · **Fax:** (507) 474-4774
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1981
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Other 0121686 (MN); Other HP32318 (MN); Other 679G2SM (MN); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1003836701) · Data from the CMS NPPES public registry.