Dr Douglas Roland Smith, MD is a medicare enrolled "Family Medicine" physician in Holladay, Utah. He went to Medical College Of Wisconsin and graduated in 2003 and has 22 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Intermountain Healthcare Services, Inc and his current practice location is
4544 S Holladay Blvd, Holladay, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 682-6817.
Dr Douglas Roland Smith is licensed to practice in Utah (license number 56913841205) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1174681928.
Physician's Profile
| Full Name | Dr Douglas Roland Smith |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 22 Years |
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| Location | 4544 S Holladay Blvd, Holladay, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Douglas Roland Smith attended and graduated from Medical College Of Wisconsin in 2003
NPI Data:
- NPI Number: 1174681928
- Provider Enumeration Date: 12/05/2006
- Last Update Date: 01/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 3274596184
- Enrollment ID: I20041110001076
Medical Identifiers
Medical identifiers for Dr Douglas Roland Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174681928 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QH0002X | Family Medicine - Hospice And Palliative Medicine | 56913841205 (Utah) | Secondary |
| 207Q00000X | Family Medicine | 56913841205 (Utah) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Intermountain Healthcare Services, Inc | 1850209420 | 3228 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Douglas Roland Smith allows following entities to bill medicare on his behalf.
| Entity Name | Ihc Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942325154
PECOS PAC ID: 1850209420
Enrollment ID: O20080610000303 |
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| Entity Name | Health Diversified - Medical Group Of Utah Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508518085
PECOS PAC ID: 8325401169
Enrollment ID: O20230828001901 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Douglas Roland Smith is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Douglas Roland Smith, MD
4417 S Doris Way,
Holladay, UT 84124-3525
Ph: (801) 682-6817 | Dr Douglas Roland Smith, MD
4544 S Holladay Blvd,
Holladay, UT 84117-4404
Ph: (801) 682-6817 |
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