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
Mailing address105 Raider Blvd, Suite 101, Hillsborough, NJ 08844-1528

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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