MEDICARE: DR. ANDREW THOMAS SMITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MA06618600	NJ
2	174400000X	Specialist	MD042636L	PA
3	208600000X	Surgery Physician	MD042636L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020043562	OTHER	PA	RAILROAD MEDICARE
13	020043562	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	223676672	OTHER	NJ	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	1085642	OTHER	NJ	HORIZON NJ HEALTH
8	223676672	OTHER	PA	AETNA
9	2163626	OTHER	NJ	AETNA USHC
10	2163726	OTHER	PA	AETNA USHC
11	223676672	OTHER	NJ	BEECHSTREET
12	959505	OTHER	PA	BLUE CROSS/SHEILD
14	223676672	OTHER	PA	BEECHSTREET
15	223676672	OTHER	NJ	CONSUMER HEALTH NETWORK
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	1522199	OTHER	NJ	GATEWAY HEALTHPLAN
18	223676672	OTHER	NJ	DEVON

General Provider Information

NPI Number	:	1821076548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW THOMAS SMITH M.D.

Provider Business Mailing Address
First Line	:	525 IRON ST
Second Line	:	SUITE B
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-1949
Country	:	US
Telephone Number	:	610-826-5052
Fax Number	:	610-681-3468

Provider Business Practice Location Address
First Line	:	450 S WASHINGTON ST
Second Line	:
City	:	GETTYSBURG
State	:	PA
Zip	:	17325-2500
Country	:	US
Telephone Number	:	717-339-3110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	03/19/2025

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