Shjade Carolina Smith, APRN-PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Tea, South Dakota. Her current practice location is
300 W Maple St, Tea, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 261-4103.
Shjade Carolina Smith is licensed to practice in South Dakota (license number CP002571) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710696919.
Provider's Profile
| Full Name | Shjade Carolina Smith |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 300 W Maple St, Tea, South Dakota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1710696919
- Provider Enumeration Date: 11/16/2022
- Last Update Date: 11/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 8921457706
- Enrollment ID: I20231206001724
Medical Identifiers
Medical identifiers for Shjade Carolina Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710696919 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | CP002571 (South Dakota) | Primary |
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. Shjade Carolina Smith allows following entities to bill medicare on her behalf.
| Entity Name | City Of Sioux Falls |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932295888
PECOS PAC ID: 7810943859
Enrollment ID: O20050323000703 |
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| Entity Name | The Wellness Collective |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679195580
PECOS PAC ID: 1951722834
Enrollment ID: O20200601002419 |
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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. Shjade Carolina 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 |
|---|
Shjade Carolina Smith, APRN-PMHNP
300 W Maple St,
Tea, SD 57064-2300
Ph: () - | Shjade Carolina Smith, APRN-PMHNP
300 W Maple St,
Tea, SD 57064-2300
Ph: (605) 261-4103 |
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