Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kaitlyn Smith

Individual provider Nurse Practitioner · NPI 1083034946

Kaitlyn Smith is a Nurse Practitioner in Randolph, New Jersey. Qualified in 2014, 12 years ago. Practices with Id Care LLC, a 119-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
12
Licensed in
NJ
In the registry since
2014
Specialties on file
3

Practice location Address checks out

765 Route 10 E Ste 201
Randolph, NJ 07869-1925
Phone: (973) 479-1128
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 26NJ00498600 (NJ)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 26NJ00498600 (NJ)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 26NJ00498600 (NJ)

Record details

NPI number1083034946
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 18, 2014
Last updated in NPPESMarch 25, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Id Care Llc — 119 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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