JAY S SMITHERMAN (MD) – Internal Medicine Physician, NPI 1225028053

JAY S SMITHERMAN (MD) is a healthcare provider. based in Portland, Oregon. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. MD60003286 (WA). The NPI Number for JAY S SMITHERMAN (MD) is 1225028053

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
JAY S SMITHERMAN (MD)
NPI
1225028053
Phone
(360) 486-6508
Address
PO BOX 3360
Enumeration Date
24 October 2005
Last Update Date
24 March 2021

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
7911950019
Group Practice PAC ID
6709782600
Professional Enrollment ID
I20080716000850
Address ID
WA985065101OL525XXNEXX400

Contacts

Secure Messaging
jsmitherman92248@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

4,056 INTERNAL MEDICINE in WA

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Provider Addresses for JAY S SMITHERMAN (MD)

  • 3360, Southwest 87th Avenue, Raleigh West, Portland, Metro, Washington County, Oregon, 97225, United States

    PORTLAND, OR 972083360

    Phone: (360) 486-6508

    Type: Mailing

  • 2555, Marvin Road Northeast, Lacey, Thurston County, Washington, 98516, United States

    PMG SW WA HAWKS PRAIRIE IM

    LACEY, WA 985163138

    Phone: (360) 923-4600

    Fax: (360) 923-4663

    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: 2008-07-16

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080716000850IInternal MedicineWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9464$0
99213Established patient office or other outpatient visit, 20-29 minutes4140$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1818$0
G0008Administration of influenza virus vaccine1715$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage1515$0
View full utilization report →

Insurance plans in this area (ZIP 97208)

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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: 6709782600View full group profile
NameSpecialtyState
U R O L O G YWA
H E M A T O L O G Y/ O N C O L O G YWA
Gynecological Oncology, Obstetrics/GynecologyCA
-OR
Certified Nurse Midwife (Cnm)WA
O B S T E T R I C S/ G Y N E C O L O G YWA
-WA
Physician AssistantWA
-WA
-WA

Reviews

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Frequently asked questions

Does JAY S SMITHERMAN (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JAY S SMITHERMAN (MD) uses 1225028053.
Can I rely on JAY S SMITHERMAN (MD) being an active provider?
As of the registry snapshot, JAY S SMITHERMAN (MD) is marked active.
What is JAY S SMITHERMAN (MD)'s specialty?
The listing groups JAY S SMITHERMAN (MD) with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does JAY S SMITHERMAN (MD) serve?
JAY S SMITHERMAN (MD)'s listing highlights Portland, Oregon; more addresses can appear in NPPES.
Is the information about JAY S SMITHERMAN (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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