Sophia Smith , RDN

Years since graduation

4 years (graduated 2022)

CMS Doctors and Clinicians data list 2022 as the year this clinician finished professional school.

It tells you roughly how long ago the clinician finished school.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Ask the office before your visit. If a clinician does not accept assignment for a service, they can charge up to 15% more than the Medicare-approved amount, and you may be asked to pay the full amount at the visit.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Sophia Smith has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means