Jill Denise Smith Radkowiec, OD
Individual provider Active NPI Optometrist · California, MO
NPI 1114239092 · NPPES record last updated Jul 8, 2010
Key facts
- NPI
- 1114239092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2010020657 (MO)
- Practice address
- 202 E North Street
California, MO 65018 - Phone
- (573) 796-2222
- Fax
- (573) 796-4184
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Columbia Eye Consultants Optometry
Practice addresses (Care Compare)
900 W Nifong Blvd
Suite 125
Columbia, MO 65203-4469
Phone (573) 874-2030
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 44 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100825001028 | MO | Practitioner - Optometry | 4880718956 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010020657 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| International Eyecare Center Inc | Optometrist | Current |
Accepting new patients |
| Paige Hedgpath Odpc | Optometrist | Current |
Accepting new patients |
| International Eyecare Center, Inc | Optometrist | Current |
Accepting new patients |
| International Eyecare Center LLC | Optometrist | Current | Accepting new patients |
| Columbia Eye Consultants Optometry | Optometrist | Current |
Accepting new patients |
| Central Missouri Dermatology Associates, LLP | Current |
Accepting new patients | |
| Paige Hedgpath OD,PC | Optometrist | Current |
Accepting new patients |
| Columbia Eyewear | Past | Accepting new patients |
Locations
202 E North St
California, MO 65018
Phone (573) 796-2222
900 W Nifong Blvd
Ste 125
Columbia, MO 65203
Phone (573) 874-2030
1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331
500 N Keene St
Ste 103
Columbia, MO 65201
Phone (573) 874-2030
2011 Corona Rd
Columbia, MO 65203
Phone (314) 523-3480
215 Progress Rd
Hannibal, MO 63401
Phone (573) 248-1616
323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313
1705 Christy Dr
Ste 208
Jefferson Cty, MO 65101
Phone (573) 644-9955
1705 Prospect Dr
Macon, MO 63552
Phone (660) 385-5724
1200 E Campbell Rd
Ste 108
Richardson, TX 75081
Phone (972) 370-5552
Interoperability endpoints
- jill.radkowiec@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2010020657 | MO | Yes |
Addresses
Primary practice location
202 E North Street
California, MO 65018
Mailing address
PO Box 246
California, MO 65018
Phone (573) 796-2222
Other names
- Jill Denise Smith
Other providers in California, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.