Individual provider Active NPI

Russell Smith, O.D.

  • Optometrist
  • Bellevue, NE
National Provider Identifier
1285687442
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
972 Issued in NE
Practice address
601 Galvin Rd S
Bellevue, NE 68005-2249
Phone
(402) 293-1840
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 972 NE Primary

Addresses

Primary practice location

601 Galvin Rd S
Bellevue, NE 68005-2249

Mailing address

601 Galvin Rd S
Bellevue, NE 68005-2249
Phone (402) 293-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20041221000741 NE Practitioner - Optometry 7315905452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

3044 S 84TH St
1 Shopko Optical 4044
Omaha, NE 68124-3208
Phone (402) 391-1143

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients
Shopko Stores Operating Co. LLC CurrentSince May 5, 2006 Accepting new patients
Shopko Stores Operating Co. LLC CurrentSince May 5, 2006 Accepting new patients

Locations

3271 Market Place Dr
#4180
Council Bluffs, IA 51501
Phone (712) 366-0706

601 Galvin Rd S
Bellevue, NE 68005
Phone (402) 293-1840

2208 N Webb Rd
#4038
Grand Island, NE 68803
Phone (308) 382-7661

100 S 66th St
Lincoln, NE 68510
Phone (402) 489-7148

4200 S 27th St
Lincoln, NE 68502
Phone (402) 421-2444

3044 S 84th St
Ste 1
Omaha, NE 68124
Phone (402) 391-1143

700 Pilgrim Way
Green Bay, WI 54304
Phone (920) 429-4218

Organizations & group practices 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1285687442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GALVIN RD S",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052249",
            "telephone_number": "402-293-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GALVIN RD S",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052249",
            "telephone_number": "402-293-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.