Jaqualla Smith, - Medicare Physician Assistant in Charleston, WV

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Jaqualla Smith, is a medicare enrolled "Physician Assistant" in Charleston, West Virginia. Her current practice location is 4407 Maccorkle Ave Se Ste 2, Charleston, West Virginia. You can reach out to her office (for appointments etc.) via phone at (304) 925-0392.

Jaqualla Smith is licensed to practice in West Virginia (license number 2910) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1902519978.

Contact Information

Jaqualla Smith,
4407 Maccorkle Ave Se Ste 2,
Charleston, WV 25304-2541
(304) 925-0392
Not Available

Map and Direction




Provider's Profile

Full NameJaqualla Smith
GenderFemale
SpecialityPhysician Assistant
Location4407 Maccorkle Ave Se Ste 2, Charleston, West Virginia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1902519978
  • Provider Enumeration Date: 01/04/2023
  • Last Update Date: 07/22/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9436699063
  • Enrollment ID: I20240910003956

Medical Identifiers

Medical identifiers for Jaqualla Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902519978NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 2910 (West Virginia)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. Jaqualla Smith allows following entities to bill medicare on her behalf.
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Public Health/welfare Agency
Entity IdentifiersNPI Number: 1124323340
PECOS PAC ID: 9931017969
Enrollment ID: O20120917000531
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720333461
PECOS PAC ID: 9931017969
Enrollment ID: O20130319000031
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659769776
PECOS PAC ID: 9931017969
Enrollment ID: O20151015002625
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700446929
PECOS PAC ID: 9931017969
Enrollment ID: O20191202000085
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407466535
PECOS PAC ID: 9931017969
Enrollment ID: O20201121000107
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912693458
PECOS PAC ID: 9931017969
Enrollment ID: O20230915003506
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366212326
PECOS PAC ID: 9931017969
Enrollment ID: O20240528000174
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144096082
PECOS PAC ID: 9931017969
Enrollment ID: O20240925002809
Entity NameValley Health Systems, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215707278
PECOS PAC ID: 9931017969
Enrollment ID: O20250203002432

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. Jaqualla 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 AddressPractice Location Address
Jaqualla Smith,
632 Hal Greer Blvd Apt 3,
Huntington, WV 25701-2975

Ph: (304) 222-4593		Jaqualla Smith,
4407 Maccorkle Ave Se Ste 2,
Charleston, WV 25304-2541

Ph: (304) 925-0392

Reviews and Comments


Physician Assistant Nurses in Charleston, WV

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Madison Mckay, PA-C
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Phone: 304-388-4172    
Katie Preece,
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Medicare: Accepting Medicare Assignments
Practice Location: 3200 Maccorkle Ave Se Ste B-16, Charleston, WV 25304
Phone: 304-388-5848    Fax: 304-388-5848

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.