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

Active since July 29, 2021CLIA 50D2241280 · Certificate of Compliance
21800 MARKET PL NW STE 103, POULSBO, WA 98370(360) 291-5700(360) 291-5702 Get Directions Write a Review

NPPES record last updated: September 8, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 8, 2021, Jul 29, 2021 (2 updates tracked since 2021).

About Smithcare: Dermatology NPPES

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

SMITHCARE: DERMATOLOGY (NPI 1417620998) is a healthcare organization registered as a mohs-micrographic surgery in Poulsbo, Washington and active in the NPI registry since July 2021. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists Andrea Dawn Smith, Managing Member/physician, as its authorized official.

NPPES Registry Identity

NPI1417620998
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameSMITHCARE: GENERAL DERMATOLOGY, MOHS SURGERY & AESTHETICS PLLC
Location Address21800 MARKET PL NW STE 103Poulsbo, WA 98370-6667
Mailing Address21800 Market Pl Nw Ste 103Poulsbo, WA 98370-6667 · (360) 291-5700 · Fax (360) 291-5702
Phone(360) 291-5700
Fax(360) 291-5702
Organization SubpartNo
Authorized OfficialAndrea Dawn SmithManaging Member/physician · (360) 291-5700
Enumeration DateJuly 29, 2021
Last NPPES UpdateSeptember 8, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2021
✔ NPI 1417620998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
Also ListedClinic/CenterTaxonomy 261Q00000X
21800 MARKET PL NW STE 103, Poulsbo, WA 98370
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Other Names 1

Doing Business AsSmithcare: Dermatology

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Smithcare: Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Smithcare: Dermatology, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Katie Ernst, APRN, DNP
Nurse Practitioner
NPI 1851811327
21800 MARKETPLACE NW ST 103
Poulsbo, WA 98370
(360) 291-5700
✔ PECOS✔ Accepts Medicare2.3 mi
Jeffrey Gertner, MD
Dermatology
NPI 1912980624
21800 MARKETPLACE NW STE 103
Poulsbo, WA 98370
(360) 291-5700
✔ PECOS✔ Accepts Medicare2.3 mi
Andrea Smith, MD
Dermatology
NPI 1801064969
21800 MARKETPLACE NW STE 103
Poulsbo, WA 98370
(360) 291-5700
✔ PECOS✔ Accepts Medicare2.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 50D2241280

Smithcare Dermatology · Poulsbo, WA
Active · expires Apr 4, 2028
CLIA Number50D2241280
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2021
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAndrea D. Smith
Laboratory Phone(360) 291-5700
Laboratory LocationSmithcare Dermatology21800 Market Pl NW Ste 103, Poulsbo, WA 98370
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC's NPI number?

The NPI number for Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC is 1417620998. It was assigned to this organization in the NPPES registry on July 29, 2021. The provider is doing business as Smithcare: Dermatology.

Where is Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC located?

Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC is located at 21800 Market Pl NW Ste 103, Poulsbo, WA 98370. The listed phone number is (360) 291-5700.

What is Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC enrolled in Medicare?

Yes. Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC, in Dermatology and Nurse Practitioner. A 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 the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D2241280) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC was last updated on September 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.