Active NPI
Roland Theodore Smith, M.D.
- Ophthalmology Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 151173-1
- Practice address
- 635 W 165TH St
Box 92
New York, NY 10032-3724 - Phone
- (212) 283-5222
- NPI assigned
- Jul 20, 2006
- Last updated
- May 9, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 151173-1 | NY | Primary |
Addresses
Primary practice location
635 W 165TH St
Box 92
New York, NY 10032-3724
Mailing address
635 W 165TH St
Box 92
New York, NY 10032-3724
Phone (212) 283-5222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01113964 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Albert Einstein College of Medicine of Yeshiva University, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
310 E 14TH St
Opthalmology Department of Mount Sinai
New York, NY 10003-4201
Phone (212) 241-0939
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151173-1 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Ophthalmology | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Ophthalmology | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Past | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Ophthalmology | Past | Accepting new patients |
Locations
218 2nd Ave
New York, NY 10003
Phone (212) 979-4000
310 E 14th St
New York, NY 10003
Phone (212) 979-4000
310 E 14th St
Ste 319
New York, NY 10003
Phone (212) 979-4500
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- rsmith@efp1740.srs-direct.com
- rsmith682927@nychhc.direct-ci.com
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.
-
dba Ophthalmology Department of Mount Sinai
- Ophthalmology Physician
- New York, NY
- NPI 1437421252
-
dba New York Eye & Ear Optical Shop
- Eyewear Supplier
- New York, NY
- NPI 1760227466
Ophthalmology
-
dba OB/GYN Department of Mount Sinai
- Obstetrics & Gynecology Physician
- New York, NY
- NPI 1124392212
-
dba Department of Ophthalmology
- Ophthalmology Physician
- New York, NY
- NPI 1790732352
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- New York City, NY
- NPI 1245251222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368057600000",
"number": "1174543029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 W 165TH ST",
"address_2": "BOX 92",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323724",
"telephone_number": "212-283-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 W 165TH ST",
"address_2": "BOX 92",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323724",
"telephone_number": "212-283-5222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ROLAND",
"middle_name": "THEODORE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2013-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "151173-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01113964",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.