Individual provider Active NPI

Ronald Neal Smith, OD

  • Optometrist
  • Tyler, TX
National Provider Identifier
1215920111
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2252T Issued in TX
Practice address
2732 S Broadway Ave
Tyler, TX 75701-5412
Phone
(903) 597-9020
Fax
(903) 597-4049
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2252T TX Primary

Addresses

Primary practice location

2732 S Broadway Ave
Tyler, TX 75701-5412

Mailing address

2732 S Broadway Ave
Tyler, TX 75701-5412
Phone (903) 597-9020

Other identifiers 1

IdentifierTypeStateIssuer
80314QOtherTXBLUECROSSBLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080414000183 TX Practitioner - Optometry 9739266859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Ronald N Smith Optometrist IncGroup PAC ID 2860579976, 2 clinicians

Practice addresses (Care Compare)

2732 S Broadway Ave
Tyler, TX 75701-5412
Phone (903) 597-9020

Merit-based Incentive Payment System (MIPS)

Final score
80 of 100Reported as group
Quality
60
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2252TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ronald N Smith Optometrist Inc Optometrist CurrentSince Jun 3, 1993 Accepting new patients

Locations

2732 S Broadway Ave
Tyler, TX 75701
Phone (903) 597-9020

Interoperability endpoints

  • Direct secure messaging: rsmith@eyesoftyler.eyefinity-direct.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1215920111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015412",
            "telephone_number": "903-597-9020",
            "fax_number": "903-597-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015412",
            "telephone_number": "903-597-9020",
            "fax_number": "903-597-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RONALD",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2252T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "80314Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.