SMITHCARE: DERMATOLOGY
NPI 1417620998
Dermatology - MOHS-Micrographic Surgery in Poulsbo, WA

NPI Status: Active since July 29, 2021

Contact Information

21800 MARKET PL NW STE 103
POULSBO, WA
ZIP 98370
Phone: (360) 291-5700
Fax: (360) 291-5702

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  • Organization
  • Dermatology
  • MOHS-Micrographic Surgery
  • CLIA Number: 50D2241280
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-04-2028

About SMITHCARE: DERMATOLOGY

This page provides the complete NPI Profile along with additional information for Smithcare: Dermatology, a provider established in Poulsbo, Washington operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1417620998 assigned on July 2021. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Smithcare: Dermatology operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Smithcare: Dermatology. The authorized official of this NPI record is Andrea Dawn Smith Md (Managing Member/physician)

NPI
1417620998
Provider Legal Name
SMITHCARE: GENERAL DERMATOLOGY, MOHS SURGERY & AESTHETICS PLLC
Other Organization Name
SMITHCARE: DERMATOLOGY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
21800 MARKET PL NW STE 103 POULSBO, WA 98370
Location Phone
(360) 291-5700
Location Fax
(360) 291-5702
Mailing Address
21800 MARKET PL NW STE 103 POULSBO, WA 98370
Mailing Phone
(360) 291-5700
Mailing Fax
(360) 291-5702
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-29-2021
Last Update Date
09-08-2021
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Location Map

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

Dermatology MOHS-Micrographic Surgery

Taxonomy Code
207ND0101X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

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)
1207N00000XAllopathic & Osteopathic Physicians

Dermatology

 
2207NS0135XAllopathic & Osteopathic Physicians

Dermatology
Procedural Dermatology

 
3261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANDREA DAWN SMITH MD

Authorized Official Title
MANAGING MEMBER/PHYSICIAN
Authorized Official Phone
(360) 291-5700

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D2241280
Facility Type
Physician Office
Certificate Effective Date
October 26, 2021
Certificate Expiration Date
April 04, 2028
Laboratory Director
ANDREA D. SMITH
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Smithcare: Dermatology after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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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 1417620998, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
8
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 1 → 2 6 → 12 → 3 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 2 + 7 + 1 + 2 + 2 + 0 + 9 + 1 + 8 + 24 = 62

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

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1417620998.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Dermatology
21800 MARKET PL NW STE 103
POULSBO, WA 98370
Physician Assistant
21800 MARKET PL NW STE 103
POULSBO, WA 98370
Physician Assistant
21800 MARKET PL NW STE 103
POULSBO, WA 98370
Nurse Practitioner (Family)
21800 MARKET PL NW STE 103
POULSBO, WA 98370
Dermatology
21800 MARKET PL NW STE 103
POULSBO, WA 98370

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417620998, enumerated as an "organization" on July 29, 2021.

The provider is located at 21800 MARKET PL NW STE 103 POULSBO, WA 98370 and the phone number is (360) 291-5700.

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.