Physician Compare National (NPI:1225041742)

HEALTHCARE PROVIDER: CLOVER SMITH NP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1225041742
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507854320
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040503000191
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	CLOVER
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	NP
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ISLAND EMERGENCY MEDICAL SERVICES PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4981503513
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	40
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	327 BEACH 19TH ST
	Group Practice or individual's line 1 address
City	FAR ROCKAWAY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	116914423
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2406862300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y