JACOB PAYNE SMITH CRNA
NPI 1275801870
Nurse Anesthetist, Certified Registered in Flagstaff, AZ

NPI Status: Active since December 09, 2011

Contact Information

77 W FOREST AVE STE 117
FLAGSTAFF, AZ
ZIP 86001
Phone: (928) 773-2505
Fax: (928) 773-2504

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  • Individual
  • Male
  • Years of Experience 15
  • Nurse Anesthetist, Certified Registered
  • Accepts Insurance
  • May Accept Medicare Approved Payment

About JACOB SMITH

This page provides the complete NPI Profile along with additional information for Jacob Smith, a provider established in Flagstaff, Arizona with a medical specialization in Nurse Anesthetist, Certified Registered and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1275801870 assigned on December 2011. The practitioner's primary taxonomy code is 367500000X with license number 0940 (AZ). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1275801870
Provider Name
JACOB PAYNE SMITH CRNA
Gender
Male
Entity Type
Individual
Location Address
77 W FOREST AVE STE 117 FLAGSTAFF, AZ 86001
Location Phone
(928) 773-2505
Location Fax
(928) 773-2504
Mailing Address
77 W FOREST AVE STE 117 FLAGSTAFF, AZ 86001
Mailing Phone
(928) 773-2505
Mailing Fax
(928) 773-2504
Medical School Name
OTHER
Graduation Year
2011
Is Sole Proprietor?
No
Enumeration Date
12-09-2011
Last Update Date
09-24-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
0940
License State
AZ
Taxonomy Description
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1163W00000XNursing Service Providers

Registered Nurse

203222 (CO)
2367500000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Anesthetist, Certified Registered

100091 (CO)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Peak PPO Bronze HDHP - PPO
  • Peak PPO Bronze Standard - PPO
  • Peak PPO Catastrophic - PPO
  • Peak PPO Gold - PPO
  • Peak PPO Gold Standard - PPO
  • Peak PPO Silver - PPO
  • Peak PPO Silver Standard - PPO
  • Plus Bronze - PPO
  • Plus Bronze Standard - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • PEAK PPO BRONZE - PPO
  • PEAK PPO BRONZE HDHP - PPO
  • PEAK PPO GOLD - PPO
  • PEAK PPO GOLD HDHP - PPO
  • PEAK PPO SILVER - PPO
  • PEAK PPO SILVER HDHP - PPO
  • Plus Bronze HDHP - PPO
  • Plus Gold HDHP - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
274331YPVEMEDICAID (05)CO 

Medicare Participation & PECOS Enrollment Status

Jacob Smith is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 9032377544

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210607002978, I20231004003816

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jacob Smith is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SIDNEY HEALTH CENTER216 14TH AVE SW
SIDNEY, MT 59270
(406) 488-2100Critical Access Hospitals
ASCENSION PROVIDENCE6901 MEDICAL PARKWAY
WACO, TX 76712
(254) 751-4000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275801870, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
8
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 8 → 16 → 7 1 → 2 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 6 + 0 + 2 + 8 + 1 + 4 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1275801870.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Anesthesiology
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001
Anesthesiology
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
77 W FOREST AVE STE 117
FLAGSTAFF, AZ 86001

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275801870, enumerated as an "individual" on December 09, 2011.

The provider is located at 77 W FOREST AVE STE 117 FLAGSTAFF, AZ 86001 and the phone number is (928) 773-2505.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.

Jacob Smith is affiliated with: SIDNEY HEALTH CENTER and ASCENSION PROVIDENCE.