GARY ALAN SMOTRICH MD
NPI 1588683098
Plastic Surgery in Lawrenceville, NJ

NPI Status: Active since July 18, 2006

Contact Information

3131 PRINCETON PIKE
BLDG 5
LAWRENCEVILLE, NJ
ZIP 08648
Phone: (609) 896-2525
Fax: (609) 896-2639

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 44
Plastic Surgery
Accepts Insurance
May Accept Medicare Approved Payment
PECOS Enrolled

About GARY SMOTRICH

This page provides the complete NPI Profile along with additional information for Gary Smotrich, a provider established in Lawrenceville, New Jersey with a medical specialization in Plastic Surgery and more than 44 years of experience. He graduated from University Of Connecticut School Of Medicine in 1982. The healthcare provider is registered in the NPI registry with number 1588683098 assigned on July 2006. The practitioner's primary taxonomy code is 208200000X with license number 25MA05344900 (NJ). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI: 1588683098
Provider Name: GARY ALAN SMOTRICH MD
Gender: Male
Entity Type: Individual
Location Address: 3131 PRINCETON PIKE BLDG 5 LAWRENCEVILLE, NJ 08648
Location Phone: (609) 896-2525
Location Fax: (609) 896-2639
Mailing Address: 3131 PRINCETON PIKE BLDG 5 LAWRENCEVILLE, NJ 08648
Mailing Phone: (609) 896-2525
Mailing Fax: (609) 896-2639
Medical School Name: UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduation Year: 1982
Is Sole Proprietor?: Yes
Enumeration Date: 07-18-2006
Last Update Date: 11-01-2007
Code Navigator

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: Plastic Surgery
Taxonomy Code: 208200000X
Type: Allopathic & Osteopathic Physicians
License No.: 25MA05344900
License State: NJ
Taxonomy Description: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Insurance Plans Accepted

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

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

Medicare

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

Medicaid

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
476133TUZ	MEDICARE PIN (08)	NJ

Medicare Participation & PECOS Enrollment Status

Gary Smotrich 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.

Gary Smotrich is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

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.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 6507818739
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: I20050222000075, I20160712000724
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.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Melanoma (skin cancer) excision

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 08648 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $94.9
Minimum New Patient Price $61.59
Maximum New Patient Price $185.05

Average New Patient Copayment $23.72
Minimum New Patient Copayment $15.39
Maximum New Patient Copayment $46.26

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $76.45
Minimum Established Patient Price $20.08
Maximum Established Patient Price $150.98

Average Established Patient Copayment $19.11
Minimum Established Patient Copayment $5.02
Maximum Established Patient Copayment $37.74

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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. Gary Smotrich is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
BETH ISRAEL DEACONESS MEDICAL CENTER	330 BROOKLINE AVENUE BOSTON, MA 02215	(617) 667-7000	Acute Care Hospitals

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	5	8	8	6	8	3	0	9	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	5	16	8	12	8	6	0	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 6 + 8 + 1 + 2 + 8 + 6 + 0 + 1 + 8 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 8									8

The NPI number 1588683098 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. SANDRO LAROCCA M.D.

Specialist

3131 PRINCETON PIKE
BUILDING 6, SUITE 106
LAWRENCEVILLE, NJ
ZIP 08648

About GARY SMOTRICH

Location Map

Specialty - Primary Taxonomy

Plastic Surgery

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 6507818739

PECOS Enrollment ID: I20050222000075, I20160712000724

Accepts Medicare Assignment? Maybe

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Melanoma (skin cancer) excision

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Find Provider Hospital Affiliations - Privileges

Reviews for GARY ALAN SMOTRICH MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions