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Deactivated NPI 1275594269 Deactivated / Inactive NPI Male Practitioner

Dr. Stephen A Smith , MD

Specialist • Pueblo, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Stephen Smith has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 29, 2006
NPI Deactivation Date May 30, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Stephen Smith, MD was a registered Specialist practicing in Pueblo, CO. Throughout an active medical career spanning 12 years, Dr. Smith provided care at the practice location at 1619 N GREENWOOD ST until profile deactivation on 2018-05-30.

Historical Medicare Part B clinical services included established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1619 N Greenwood St
Suite 402

Pueblo, CO 810032658

Telephone 7195957760
Fax 7195957765
Associated Practice Facility / Clinic
🏢 Radiology Associates Facility NPI 1043206311

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Pueblo, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 42.3 Yrs
State Avg: 33.7 Yrs
Regional Practice Density
35 Specialists

Practicing in Pueblo, CO (1204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
33.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
17 17 $113.00 $74.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
12 12 $166.00 $110.03

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MN 17784

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1730216771

Doctor of Naturopathic Medicine, Clinical Nurse Specialist, ACHPN, CCM

Dr. Gary Cohen , MD

Psychiatry & Neurology - Neurology

NPI 1992744163

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated May 30, 2018

Record deactivated on May 30, 2018

NPI Profile Active January 25, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address January 25, 2017

Registered at PO BOX 560825, DENVER, CO 802560825 (Tel: 7195957580)

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Updated Practice Location January 25, 2017

Registered at 1619 N GREENWOOD ST, SUITE 402, PUEBLO, CO 810032658 (Tel: 7195957760)

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Provider Name / Credentials Updated January 25, 2017

Recorded as STEPHEN SMITH, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2017

Specialist (License #17784 in MN)

NPI Profile Active August 30, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location August 30, 2012

Registered at 1619 N GREENWOOD ST, SUITE 402, PUEBLO, CO 810032658 (Tel: 7195957760)

📍
Updated Business Mailing Address August 30, 2012

Registered at 1619 N GREENWOOD ST, SUITE 402, PUEBLO, CO 810032658 (Tel: 7195957760)

👤
Provider Name / Credentials Updated August 30, 2012

Recorded as STEPHEN SMITH, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2012

Specialist (License #17784 in MN)

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Initial NPI Registration & Enumeration March 29, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275594269
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 29, 2006
Last Update: August 30, 2012
Deactivation Date: May 30, 2018

Mailing Address

1619 N Greenwood St, Suite 402

Pueblo, CO 810032658

Phone: 7195957760

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.