JORDAN SMITH (D.O.) – Surgery Physician, NPI 1023464609
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
772 GENERAL SURGERY in AZ
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Provider Addresses for JORDAN SMITH (D.O.)
1616 S PIONEER WAY
MOSES LAKE, WA 988372487
Phone: (509) 793-9715
Fax: (509) 764-3244
Type: Mailing
660 S COOLIDGE ST
MOSES LAKE, WA 988371872
Phone: (509) 793-9715
Fax: (509) 764-3244
Type: Mailing
1301, South Crismon Road, Mesa, Maricopa County, Arizona, 85209, United States
MESA, AZ 852093767
Phone: (480) 373-2370
Fax: (480) 373-2375
Type: Mailing
1550 S PIONEER WAY
MOSES LAKE, WA 988374613
Phone: (509) 793-9792
Fax: (509) 764-3287
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 35 Open Payments records for all available years, with a total value of $18,766.
Total Amount is formed as General ($18,766) + Research ($0) + Ownership ($0) = $18,766.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($18,459).
Total Amount
$18,766
General + Research + Ownership
Payments
35
Total payment records
General Amount
$18,766
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $18,459 |
| Organogenesis Inc. | $241 |
| Innovation Technologies Inc | $67 |
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: 2021-09-09
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20210909003418 | I | General Surgery | WA | 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 |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 14 | 14 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 98837)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | WA | |
| - | PA | |
| Emergency Medicine | NJ | |
| Internal Medicine | IN | |
| Physician Assistant | OH | |
| Mental Health Counselor | WA | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| Hospitalist, Internal Medicine | PA | |
| Internal Medicine, Hospitalist | NC | |
| Physician Assistant | WA |
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