SPENCER SMITH PA
NPI 1679050611
Physician Assistant in Fleming Island, FL

Q: What is Spencer Smith's NPI number?

The NPI number for Spencer Smith is 1679050611. It was assigned to this individual provider in the NPPES registry on July 23, 2018.

Q: What is Spencer Smith's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Smith was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since July 23, 2018PECOS EnrolledAccepts Medicare Assignment

4565 US HIGHWAY 17 STE 106, FLEMING ISLAND, FL 32003(904) 269-4559(904) 269-4597 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 18, 2022, Jul 23, 2018 (2 updates tracked since 2018).

On this page

About Spencer Smith Pa NPPES

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

SPENCER SMITH PA (NPI 1679050611) is an individual physician assistant in Fleming Island, Florida, licensed in Florida (PA9120420) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, is affiliated with Baptist Medical Center Beaches, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1679050611

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSPENCER SMITHCredential: PA

Location Address4565 US HIGHWAY 17 STE 106Fleming Island, FL 32003-4822

Mailing Address425 W Colonial Dr Ste 303Orlando, FL 32804-6863 · (833) 702-8383 · Fax (689) 304-0303

Phone(904) 269-4559

Fax(904) 269-4597

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJuly 23, 2018

Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration

NPPES CertifiedAugust 25, 2025

✔ NPI 1679050611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9120420

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9120420 (FL)

4565 US HIGHWAY 17 STE 106, Fleming Island, FL 32003

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Spencer Smith Pa 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.

PECOS PAC ID2062763717

PECOS Enrollment IDI20250902004041

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100117

Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALI REZA AFSHAR M.D.

Family Medicine