Gary Lyle Smith, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Susanville, California. His current practice location is
1800 Spring Ridge Dr, Susanville, California. You can reach out to his office (for appointments etc.) via phone at
(530) 252-2000.
Gary Lyle Smith is licensed to practice in California (license number 2065) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063507077.
Provider's Profile
| Full Name | Gary Lyle Smith |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1800 Spring Ridge Dr, Susanville, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063507077
- Provider Enumeration Date: 10/04/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2668411307
- Enrollment ID: I20050502000794
Medical Identifiers
Medical identifiers for Gary Lyle Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063507077 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 2065 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gary Lyle Smith allows following entities to bill medicare on his behalf.
| Entity Name | Last Frontier Healthcare District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487669032
PECOS PAC ID: 2466447412
Enrollment ID: O20040419000563 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gary Lyle Smith is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Gary Lyle Smith, CRNA
1441 N 12th St,
Phoenix, AZ 85006-2837
Ph: (602) 747-4577 | Gary Lyle Smith, CRNA
1800 Spring Ridge Dr,
Susanville, CA 96130-6100
Ph: (530) 252-2000 |
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