Keith Smithson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001041 Issued in VA

Practice address

11656 Plaza America Dr
Reston, VA 20190-4767

Phone

(703) 467-9080

Fax

(703) 467-9082

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Virginia Doctors of OptometryGroup PAC ID 1759301765, 21 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northern Virginia Doctors of Optometry

  • Optometrist
  • Falls Church, VA
  • NPI 1801976055

  DC

  Medicare reassignment Care Compare group NPD
• Sonus-USA, Inc.

  • Audiologist-Hearing Aid Fitter
  • Eugene, OR
  • NPI 1780765099
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154339687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7263E ARLINGTON BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423219",
            "telephone_number": "703-573-1200",
            "fax_number": "703-573-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11656 PLAZA AMERICA DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904767",
            "telephone_number": "703-467-9080",
            "fax_number": "703-467-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHSON",
        "first_name": "KEITH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS/RESTON",
            "identifier": "383934",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS/ALEXANDRIA",
            "identifier": "383935",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009232231",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2663321",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA  PPO",
            "identifier": "7671300",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/CAREFIRST",
            "identifier": "9314-0007",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ALLIANCE",
            "identifier": "295571",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Susan Small, LPC, NCC
• Pranee Chanthavongsa Smarsh, NP
• Smile Reston Heights
• Heather Smith
• Victoria Genevieve Smith
• Mary Jo Smrekar, PH.D.
• Rosalyn Yvette Sneed, FNP
• Lisa Maestri Snipper
• Doris Jean Snow, PHD
• Kimberly A Snow, PA-C

• Optometrist in Reston, VA
• Providers in Reston, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.