KENNETH M SMITH (MD) – Urology Physician, NPI 1982807350
Urology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
284 UROLOGY in MN
Provider Addresses for KENNETH M SMITH (MD)
1025 Marsh St
Mankato, MN 560014752
Phone: (507) 625-4031
Type: Location
435 Phalen Blvd - MS 51103C
HealthPartners Specialty Center 435
St. Paul, MN 551305302
Phone: (651) 254-8500
Fax: (651) 254-8504
Type: Location
33rd Avenue South, Wenonah, Minneapolis, Hennepin County, Minnesota, 55417, United States
MS21110Q
MINNEAPOLIS, MN 554254516
Phone: (952) 883-5375
Fax: (651) 254-8504
Type: Mailing
Mayo Clinic Health System, 1025, Marsh Street, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO, MN 560014752
Phone: (507) 625-4031
Type: Location
1805 HENNEPIN AVE N
GLENCOE, MN 553361416
Phone: (320) 864-3121
Fax: (320) 864-7892
Type: Mailing
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: 2010-11-16
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 |
|---|---|---|---|---|
| I20101116001126 | I | Urology | MN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56001)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | OK | |
| Physician Assistant | MN | |
| Emergency Medicine | MN | |
| Family Practice | MN | |
| Family Practice | MN | |
| Nurse Practitioner | MN | |
| Orthopedic Surgery | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| - | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN |
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