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NICOLE SMITH PA
NPI 1053941674
Physician Assistant in Bangor, MI

Active since January 23, 2020PECOS EnrolledAccepts Medicare Assignment
520 RAILROAD ST, BANGOR, MI 49013(269) 427-5811 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 11, 2024, Oct 19, 2021, Jan 23, 2020 (3 updates tracked since 2020).

About Nicole Smith Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE SMITH PA (NPI 1053941674) is an individual physician assistant in Bangor, Michigan, licensed in Michigan (5601009812) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1053941674
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameNICOLE SMITHCredential: PA
Location Address520 RAILROAD STBangor, MI 49013-1490
Mailing Address601 John Street, Box 42Kalamazoo, MI 49007
Phone(269) 427-5811
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 23, 2020
Last NPPES UpdateNovember 11, 20243 updates tracked since enumeration
NPPES CertifiedNovember 11, 2024
✔ NPI 1053941674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601009812
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
520 RAILROAD ST, Bangor, MI 49013
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

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

Nicole Smith Pa 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.

PECOS PAC ID3971930546
PECOS Enrollment IDI20200219002687
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230017
Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County
Emergency services Birthing friendly

Bronson South Haven Hospital

Acute Care Hospitals · South Haven, MI
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230085
Location955 S Bailey AveSouth Haven, MI 49090 · Van Buren County
Emergency services

Bronson Lakeview Hospital

Critical Access Hospitals · Paw Paw, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231332
Location408 Hazen StreetPaw Paw, MI 49079 · Van Buren County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRONSON LAKEVIEW HOSPITAL
Clinic/Center (Rural Health)
520 RAILROAD ST
BANGOR, MI 49013
Van Buren County (269) 427-5811
DR. DAVID LYMAN MD
Family Medicine
520 RAILROAD ST
BANGOR, MI 49013
Van Buren County (269) 427-5811
MRS. RHONDA L. SHINAULT P.A.-C
Physician Assistant
520 RAILROAD ST
BANGOR, MI 49013
Van Buren County (269) 427-5811
CARALYN DEHAAN D.O.
Family Medicine
520 RAILROAD ST
BANGOR, MI 49013
Van Buren County (269) 427-5811

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 Nicole Smith's NPI number?

The NPI number for Nicole Smith is 1053941674. It was assigned to this individual provider in the NPPES registry on January 23, 2020.

Where is Nicole Smith located?

Nicole Smith practices at 520 Railroad St, Bangor, MI 49013. The listed phone number is (269) 427-5811.

What is Nicole Smith's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicole Smith enrolled in Medicare?

Yes. Nicole 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.

What insurance does Nicole Smith accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Nicole Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicole Smith affiliated with any hospitals?

According to CMS data, Nicole Smith is affiliated with Bronson Methodist Hospital, Bronson South Haven Hospital and Bronson Lakeview Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Smith was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.