MCKOTAH BRICE SMITH (PA) – Physician Assistant, NPI 1508508409

MCKOTAH BRICE SMITH (PA) is a healthcare provider. based in Healdton, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for MCKOTAH BRICE SMITH (PA) is 1508508409

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
MCKOTAH BRICE SMITH (PA)
NPI
1508508409
Phone
(580) 229-0701
Address
3462 HOSPITAL RD
Enumeration Date
11 April 2022
Last Update Date
23 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5802290079
Graduation Year
2022 (4 years ago)
PAC ID
7911387055
Group Practice PAC ID
3375610447
Professional Enrollment ID
I20220706003499
Address ID
OK734386124HE3472XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:4State licenses:0Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for MCKOTAH BRICE SMITH (PA)

  • 3462 HOSPITAL RD

    HEALDTON, OK 734386124

    Phone: (580) 229-0701

    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)

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: 2022-07-06

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
I20220706003499IPhysician AssistantOKTBD

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 73438)

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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: 3375610447View full group profile
NameSpecialtyState
Nurse PractitionerOK
Internal MedicineOK
Nurse PractitionerOK
Physician AssistantOK
Family PracticeOK
-OK
Physician AssistantOK
Internal MedicineOK
Nurse PractitionerOK
Internal MedicineOK

Reviews

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Frequently asked questions

Can I verify MCKOTAH BRICE SMITH (PA) with an NPI only?
You can start verification with NPI 1508508409 for MCKOTAH BRICE SMITH (PA), then check state licensing separately.
Does CMS list MCKOTAH BRICE SMITH (PA) as active?
Yes — MCKOTAH BRICE SMITH (PA) is active in the NPI listing used on this page.
What is MCKOTAH BRICE SMITH (PA)'s primary classification?
Physician Assistant is the headline specialty for MCKOTAH BRICE SMITH (PA) here. Clinical services aligned with this taxonomy classification.
Where is MCKOTAH BRICE SMITH (PA) based?
MCKOTAH BRICE SMITH (PA) is tied to Healdton, Oklahoma in the data we show; additional addresses may exist on the full record.
Why does MCKOTAH BRICE SMITH (PA) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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