Stacy Marie Smith, FNP is a medicare enrolled "Family Medicine" in Auburn, Indiana. Her current practice location is
1310 E 7th St., Ste J, Auburn, Indiana. You can reach out to her office (for appointments etc.) via phone at
(260) 925-0305.
Stacy Marie Smith is licensed to practice in Indiana (license number 351434141) 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 1407139546.
Provider's Profile
Full Name | Stacy Marie Smith |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 1310 E 7th St., Ste J, Auburn, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407139546
- Provider Enumeration Date: 09/26/2011
- Last Update Date: 12/31/2019
Medicare PECOS Information:
- PECOS PAC ID: 8628241445
- Enrollment ID: I20111024000019
Medical Identifiers
Medical identifiers for Stacy Marie Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407139546 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 28131467A (Indiana) | Secondary |
363LF0000X | Nurse Practitioner - Family | 71003749A (Indiana) | Secondary |
207Q00000X | Family Medicine | 351434141 (Indiana) | 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. Stacy Marie Smith allows following entities to bill medicare on her behalf.
Entity Name | Mark S Souder |
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Entity Type | Practitioner - Family Practice |
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Entity Identifiers | NPI Number: 1245218973 PECOS PAC ID: 8921038381 Enrollment ID: I20111216000711 |
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Entity Name | The Otis R Bowen Center For Human Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1639172810 PECOS PAC ID: 7618950965 Enrollment ID: O20050404000853 |
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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. Stacy Marie 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 |
Stacy Marie Smith, FNP 1310 E 7th St Ste J, Auburn, IN 46706-2518 Ph: (260) 925-0305 | Stacy Marie Smith, FNP 1310 E 7th St., Ste J, Auburn, IN 46706 Ph: (260) 925-0305 |
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