Allen Ralph Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004302 Issued in MI

Practice address

597 Baldwin St
Jenison, MI 49428-7994

Phone

(616) 457-0760

Fax

(616) 457-0762

NPI assigned

Jun 29, 2006

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: direct@lifetimeeyecarejenisonmi.compulinkdirect.com

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.

• Lifetime Eyecare P C

  • Optometrist
  • Jenison, MI
  • NPI 1285836213
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1255369138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8134 WARNER ST",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019610",
            "telephone_number": "616-819-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287994",
            "telephone_number": "616-457-0760",
            "fax_number": "616-457-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALLEN",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Shuckerow
• Madison Simmon
• Joshua Simpson
• Colleen Skuza, M.A., CF-SLP
• Gracen Loraine Smit, LLPC
• Heather Lyn-Nieboer Smith, ATC
• Logan Conrad Smith, DDS
• Natalie Smith
• Scott Edward Sorensen, R.PH.
• Space for Change Therapeutic Services, LLC

• Optometrist in Jenison, MI
• Providers in Jenison, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.