Beverly Jue Smith, OD, MS, MBA, CPNP
Individual provider Active NPI Optometrist · Alamo, CA
NPI 1114918802 · NPPES record last updated Jun 28, 2025
Key facts
- NPI
- 1114918802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8094TPG (CA)
- Practice address
- 3000 Danville Blvd Ste I
Alamo, CA 94507-1572 - Phone
- (925) 202-2846
- NPI assigned
- Nov 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20081126000352 | CA | Practitioner - Optometry | 3678662566 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner, Master of Business Administration, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8094T | CA | MD | Optometrist |
| 8094TPG | CA | MD | Optometrist |
| 2921T | OR | MD | Optometrist |
| 8094 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poplar Spectacles Optometry, Inc. | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2921T | OR | |
| Optometrist | 152W00000X | 8094 | CA | |
| Optometrist | 152W00000X | 8094T | CA | |
| Optometrist | 152W00000X | 8094TPG | CA | Yes |
Addresses
Primary practice location
3000 Danville Blvd Ste I
Alamo, CA 94507-1572
Mailing address
PO Box 1973
Danville, CA 94526-6973
Phone (925) 487-3747
Other providers in Alamo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.