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DR. EDWARD LAWRENCE SMITH D.O.
NPI 1962617845
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Sheboygan, WI

Active since May 13, 2007PECOS EnrolledAccepts Medicare Assignment
82.77/100
CMS Quality Rating
1411 N TAYLOR DR, SHEBOYGAN, WI 53081(616) 735-3257 Get Directions Write a Review

NPPES record last updated: September 15, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Edward Lawrence Smith D.o. NPPES

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

DR. EDWARD LAWRENCE SMITH D.O. (NPI 1962617845) is an individual otolaryngology/facial plastic surgery provider in Sheboygan, Wisconsin, licensed in Wisconsin (55826-21) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1962617845
Entity TypeIndividualMale
Primary Taxonomy207YX0905X
Provider Legal NameDR. EDWARD LAWRENCE SMITHCredential: D.O.
Location Address1411 N TAYLOR DRSheboygan, WI 53081-3043
Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 457-2100
Phone(616) 735-3257
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMay 13, 2007
Last NPPES UpdateSeptember 15, 2016
✔ NPI 1962617845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
Licenses✔ Licensed in WI · 55826-21✔ Licensed in MI · 5101016859
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
1411 N TAYLOR DR, Sheboygan, WI 53081
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

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

Dr. Edward Lawrence Smith D.o. 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 ID8921277336
PECOS Enrollment IDI20110801000592
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
114 services82 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
89 services75 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
61 services61 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
56 services53 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
53 services44 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
50 services34 patients

Hospital Affiliations CMS Care Compare 4

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520045
Location130 2nd StNeenah, WI 54956 · Winnebago County
Emergency services Birthing friendly

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520107
Location2300 Western AveManitowoc, WI 54221 · Manitowoc County
Emergency services

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520198
Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.36
Promoting Interoperability100
Improvement Activities40
Cost57.23

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.

SUSAN ANNE EDNA EVANS DPM
Podiatrist
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
AJHANI KESAVAN MD
Family Medicine
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
MS. KAREN LU COLVIN C.R.N.A.
Nurse Anesthetist, Certified Registered
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 457-1600
MARYLOU MERCADO
Registered Nurse
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
PARAGON ANESTHESIA, LTD
Anesthesiology
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 451-8142
SHEBOYGAN EAR, NOSE & THROAT, S.C.
Otolaryngology (Facial Plastic Surgery)
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 457-2100
DR. SUZANNE S HEROLD MD
Internal Medicine
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
DR. JOSEPH C MCCORMICK III M.D.
Orthopaedic Surgery
1411 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700

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 Edward Smith's NPI number?

The NPI number for Edward Smith is 1962617845. It was assigned to this individual provider in the NPPES registry on May 13, 2007.

Where is Edward Smith located?

Edward Smith practices at 1411 N Taylor Dr, Sheboygan, WI 53081. The listed phone number is (616) 735-3257.

What is Edward Smith's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Is Edward Smith enrolled in Medicare?

Yes. Edward Smith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edward Smith accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Edward Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edward Smith affiliated with any hospitals?

According to CMS data, Edward Smith is affiliated with Thedacare Regional Med Ctr - Neenah, Holy Family Memorial, Thedacare Regional Medical Center - Appleton Inc and Aurora Medical Ctr Oshkosh.

When was this NPI record last updated?

The NPPES record for Edward Smith was last updated on September 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.