DR. KELLY SMITH (MD) – Anesthesiology Physician, NPI 1831210715

DR. KELLY SMITH (MD) is a healthcare provider. based in Jacksonville, Florida. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 4301087897 (MI). The NPI Number for DR. KELLY SMITH (MD) is 1831210715

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY SMITH (MD)
NPI
1831210715
Phone
(904) 953-2000
Address
4500 SAN PABLO RD S
Enumeration Date
2 April 2007
Last Update Date
20 July 2022

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
9549395000
Graduation Year
2006 (20 years ago)
PAC ID
4183757164
Group Practice PAC ID
4688805286
Professional Enrollment ID
I20100727001042
Address ID
FL349527521PO1800XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

3,343 ANESTHESIOLOGY in FL

Provider Addresses for DR. KELLY SMITH (MD)

  • 4500 SAN PABLO RD S

    JACKSONVILLE, FL 322241865

    Phone: (904) 953-2000

    Type: Mailing

  • 1800 SE TIFFANY AVE

    PORT ST LUCIE, FL 349527521

    Phone:

    Type: Mailing

  • 1525 W CYPRESS CREEK RD

    FORT LAUDERDALE, FL 333091831

    Phone: (954) 939-5577

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-07-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100727001042IAnesthesiologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32224)

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Provider's Procedures

DR. KELLY SMITH (MD) performs procedures in ANESTHESIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYFL00790Anesthesia for procedure in upper abdomen including use of an endoscope5454
ANESTHESIOLOGYFL01402Anesthesia for open or endoscopic total knee joint replacement1111

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688805286View full group profile
NameSpecialtyState
-FL
-MD
-FL
-FL
A N E S T H E S I O L O G YFL
-PR
-FL
A N E S T H E S I O L O G YWI
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL

Reviews

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Frequently asked questions

How do payers reference DR. KELLY SMITH (MD)?
For DR. KELLY SMITH (MD), use NPI 1831210715 as the unique 10-digit identifier.
Would DR. KELLY SMITH (MD) appear as active to a payer?
You can treat DR. KELLY SMITH (MD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. KELLY SMITH (MD)?
DR. KELLY SMITH (MD)'s record emphasizes Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Is DR. KELLY SMITH (MD) located near Jacksonville?
DR. KELLY SMITH (MD) currently maps to Jacksonville, Florida in this extract.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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