MR. DELMAR WALLACE SMITH (P.A.) – Medical Physician Assistant, NPI 1336110980
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,531 PHYSICIAN ASSISTANT in ID
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Provider Addresses for MR. DELMAR WALLACE SMITH (P.A.)
American Legion Boulevard, Mountain Home, Elmore County, Idaho, 83647, United States
MOUNTAIN HOME, ID 836473138
Phone: (208) 587-1500
Fax: (208) 587-3180
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $478.
Total Amount is formed as General ($478) + Research ($0) + Ownership ($0) = $478.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Exact Sciences Corporation ($102).
Total Amount
$478
General + Research + Ownership
Payments
21
Total payment records
General Amount
$478
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-10-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041013000360 | I | Physician Assistant | ID | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 363 | 102 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 274 | 90 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 43 | 43 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 41 | 34 | $0 |
| G0008 | Administration of influenza virus vaccine | 35 | 35 | $0 |
Insurance plans in this area (ZIP 83647)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | ID | 81002 | Urinalysis, manual test | 16 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ID | |
| Family Practice | ID |
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