1. Home
  2. Directory
  3. Connecticut
  4. New Haven
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DR. RYAN KENNETH SMITH MD
NPI 1902336977
Student in an Organized Health Care Education/Training Program in New Haven, CT

Active since June 13, 2017PECOS Enrolled
1450 CHAPEL STREET, SRC ADULT PRIMARY CARE CLINIC, NEW HAVEN, CT 06511(203) 789-4044 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jun 13, 2017 (3 updates tracked since 2017).

About Dr. Ryan Kenneth Smith Md NPPES

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

DR. RYAN KENNETH SMITH MD (NPI 1902336977) is an individual student in an organized health care education/training program in New Haven, Connecticut and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in New Haven.

NPPES Registry Identity

NPI1902336977
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. RYAN KENNETH SMITHCredential: MD
Location Address1450 CHAPEL STREET, SRC ADULT PRIMARY CARE CLINICNew Haven, CT 06511
Mailing Address1450 Chapel Street, Src Adult Primary Care ClinicNew Haven, CT 06511 · (203) 789-4044
Phone(203) 789-4044
Sole ProprietorYes
Enumeration DateJune 13, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1902336977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1450 CHAPEL STREET, New Haven, CT 06511
Open in Google Maps ↗

Secondary Practice Location 1

Location 115 York StNew Haven, CT 06510-3221 · Phone (203) 688-5303

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ryan Kenneth Smith Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

DR. RICHARD J. BARSE MD
Internal Medicine
1450 CHAPEL STREET
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-4044
DR. STEVEN J. ANGELO MD
Internal Medicine
1450 CHAPEL STREET, SAINT RAPHAEL FACULTY PHYSICIANS
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-5946
MS. DEBORAH ROSE COOKE PA-C
Physician Assistant (Surgical)
1450 CHAPEL STREET
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 415-6807
YUNG AH LEE M.D.
Internal Medicine (Geriatric Medicine)
1450 CHAPEL STREET, GERIATRIC SERVICES
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 688-8200
DR. RAVI KAZA MD
Obstetrics & Gynecology
1450 CHAPEL STREET, SAINT RAPHAEL FACULTY PHYSICIANS
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-4074
DR. GRAHAM MARK GRABOWSKI DMD
Student in an Organized Health Care Education/Training Program
1450 CHAPEL STREET, HOSPITAL OF SAINT RAPHAEL
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-3156
MR. SHANNON B KNAGGS APRN
Pediatrics
1450 CHAPEL STREET
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-4074
LYDIA SEGUI PA-C
Physician Assistant
1450 CHAPEL STREET
NEW HAVEN, CT 06511
South Central Connecticut Planning Region (203) 789-3000

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 Ryan Smith's NPI number?

The NPI number for Ryan Smith is 1902336977. It was assigned to this individual provider in the NPPES registry on June 13, 2017.

Where is Ryan Smith located?

Ryan Smith practices at 1450 Chapel Street Src Adult Primary Care Clinic, New Haven, CT 06511. The listed phone number is (203) 789-4044.

What is Ryan Smith's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ryan Smith enrolled in Medicare?

Yes. Ryan Smith is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ryan Smith was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.