Individual provider Active NPI

Kyle Alexander Smith, O.D.

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1144282476
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
359 Issued in AK
Practice address
3401 Minnesota Dr Ste 200
Anchorage, AK 99503-3684
Phone
(907) 272-9800
NPI assigned
Apr 3, 2006
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 359 AK Primary

Addresses

Primary practice location

3401 Minnesota Dr Ste 200
Anchorage, AK 99503-3684

Mailing address

3401 Minnesota Dr Ste 200
Anchorage, AK 99503-3684
Phone (907) 272-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329001689 AK Practitioner - Optometry 0749587269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benjamin Crawford LLCGroup PAC ID 9931421765, 2 clinicians

Practice addresses (Care Compare)

3401 Minnesota Dr
Suite 200
Anchorage, AK 99503-3684
Phone (907) 272-9800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
359AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin Crawford LLC Optometrist CurrentSince Jul 10, 2018 Accepting new patients
Alaska Childrens Eye and Strabismus LLC CurrentSince Jul 24, 2015 Accepting new patients
Alaska Center for the Blind and Visually Impaired PastSince Jan 1, 2020 Accepting new patients

Locations

3401 Minnesota Dr
Ste 200
Anchorage, AK 99503
Phone (907) 272-9800

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_ACES

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1144282476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 MINNESOTA DR STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033684",
            "telephone_number": "907-272-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MINNESOTA DR STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033684",
            "telephone_number": "907-272-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "middle_name": "ALEXANDER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.