DR. SHANE DAVID SMITH M.D
NPI 1124476676
Dermatology in Glen Burnie, MD
About Dr. Shane David Smith M.d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SHANE DAVID SMITH M.D (NPI 1124476676) is an individual dermatology provider in Glen Burnie, Maryland, licensed in Maryland (D0096028) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Shane David Smith M.d 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.
Medicare Billing Reassignment
Medicare enrollment records show Shane Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Annapolis, MD 21401
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- 57 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21061 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLEN BURNIE, MD 21061
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 Shane Smith's NPI number?
The NPI number for Shane Smith is 1124476676. It was assigned to this individual provider in the NPPES registry on May 25, 2016.
Where is Shane Smith located?
Shane Smith practices at 810 Landmark Dr Ste 217-219, Glen Burnie, MD 21061. The listed phone number is (443) 351-3376.
What is Shane Smith's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Shane Smith enrolled in Medicare?
Yes. Shane 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.
Which organization bills Medicare for Shane Smith's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shane Smith reassigns Medicare benefits to Anne Arundel Dermatology, LLC (Annapolis, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shane Smith was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. Shane David Smith, M.D · NPI 1124476676
Dermatology physician in Glen Burnie, Maryland. Individual provider, active in the CMS NPPES registry since May 25, 2016.
## Identity
- **NPI:** 1124476676 (Entity type: Individual)
- **Enumerated:** May 25, 2016
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **State license:** D0096028 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 810 LANDMARK DR STE 217-219, Glen Burnie, MD 21061-4987
- **Phone:** (443) 351-3376
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Anne Arundel Dermatology, LLC (NPI 1063481703, Annapolis, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** April 14, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1124476676) · Data from the CMS NPPES public registry.