JAMES DOUGLAS SMITH MD
NPI 1801883335
Internal Medicine - Nephrology in New Haven, CT
NPI Status: Active since September 30, 2005
Contact Information
136 SHERMAN AVE
STE 405
NEW HAVEN, CT
ZIP 06511
Phone: (203) 787-0117
Fax: (203) 777-3559
- Individual
- Male
- Internal Medicine
- Nephrology
- PECOS Enrolled
About JAMES SMITH
This page provides the complete NPI Profile along with additional information for James Smith, an internist established in New Haven, Connecticut with a medical specialization in Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1801883335 assigned on September 2005. The practitioner's primary taxonomy code is 207RN0300X with license number 21406 (CT). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1801883335
- Provider Name
- JAMES DOUGLAS SMITH MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 136 SHERMAN AVE STE 405 NEW HAVEN, CT 06511
- Location Phone
- (203) 787-0117
- Location Fax
- (203) 777-3559
- Mailing Address
- 136 SHERMAN AVE STE 405 NEW HAVEN, CT 06511
- Mailing Phone
- (203) 787-0117
- Mailing Fax
- (203) 777-3559
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-30-2005
- Last Update Date
- 10-11-2011
- Code Navigator
An internist like James Smith is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
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
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 21406
- License State
- CT
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| 001214064 | MEDICAID (05) | CT | |
| D88788 | MEDICARE UPIN (02) | ||
| 390000147 | MEDICARE PIN (08) | CT |
Medicare Participation & PECOS Enrollment Status
James Smith 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
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)
1 DME suppliers used 11 Medicare Claims 2200 Services Paid
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 06511 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $138.84
- Minimum New Patient Price $60.82
- Maximum New Patient Price $183.1
- Average New Patient Copayment $34.71
- Minimum New Patient Copayment $15.2
- Maximum New Patient Copayment $45.77
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $106.68
- Minimum Established Patient Price $19.76
- Maximum Established Patient Price $149.26
- Average Established Patient Copayment $26.67
- Minimum Established Patient Copayment $4.94
- Maximum Established Patient Copayment $37.31
* 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.
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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 1801883335, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
NEW HAVEN, CT 06511
NEW HAVEN, CT 06511
NEW HAVEN, CT 06511
NEW HAVEN, CT 06511
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801883335, enumerated as an "individual" on September 30, 2005.
The provider is located at 136 SHERMAN AVE STE 405 NEW HAVEN, CT 06511 and the phone number is (203) 787-0117.
Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
