JESSICA PACKER SMOOT (PA) – Family Medicine Physician, NPI 1629825823

JESSICA PACKER SMOOT (PA) is a healthcare provider. based in Idaho falls, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 1861669 (ID). The NPI Number for JESSICA PACKER SMOOT (PA) is 1629825823

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA PACKER SMOOT (PA)
NPI
1629825823
Phone
(208) 313-6033
Address
1138 MONAGHAN CT
Enumeration Date
4 May 2024
Last Update Date
17 July 2024

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE, GLENDALE
Secondary Phone
2085527700837
Graduation Year
2024 (2 years ago)
PAC ID
1052842283
Group Practice PAC ID
1052480076
Professional Enrollment ID
I20241025002430
Address ID
ID834044979ID3820XLNXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,534 PHYSICIAN ASSISTANT in ID

Provider Addresses for JESSICA PACKER SMOOT (PA)

  • 1138 MONAGHAN CT

    IDAHO FALLS, ID 834048309

    Phone: (208) 313-6033

    Type: Mailing

  • 3820 CRESTWOOD LN

    IDAHO FALLS, ID 834044979

    Phone: (208) 552-7700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $238.

Total Amount is formed as General ($238) + Research ($0) + Ownership ($0) = $238.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($78).

Total Amount

$238

General + Research + Ownership

Payments

14

Total payment records

General Amount

$238

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-10-25

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
I20241025002430IPhysician AssistantIDTBD

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 83404)

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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: 1052480076View full group profile
NameSpecialtyState
Physician AssistantID
-ID
Physical Therapist In Private PracticeID
-ID
Physician AssistantID
Physician AssistantID
-ID
Physical Therapist In Private PracticeWA
Family PracticeID
Physical Therapist In Private PracticeID

Reviews

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Frequently asked questions

What is the registry number for JESSICA PACKER SMOOT (PA)?
The registry entry for JESSICA PACKER SMOOT (PA) shows NPI 1629825823.
Does the public listing show JESSICA PACKER SMOOT (PA) as active?
JESSICA PACKER SMOOT (PA)'s NPI record reflects an active status in NPPES.
Which specialty label fits JESSICA PACKER SMOOT (PA)?
NPPES ties JESSICA PACKER SMOOT (PA) to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to JESSICA PACKER SMOOT (PA)?
The directory associates JESSICA PACKER SMOOT (PA) with Idaho Falls, Idaho. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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