Active NPI
Jinaki Tamu Smith, O.D.
- Optometrist
- Prince Frederick, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA2044
- Practice address
- 130 W Dares Beach Rd
Prince Frederick, MD 20678-3120 - Phone
- (410) 535-2020
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2621 | TN | |
| Optometrist | 152W00000X | 56007024 | NY | |
| Optometrist | 152W00000X | TA2044 | MD | Primary |
Addresses
Primary practice location
130 W Dares Beach Rd
Prince Frederick, MD 20678-3120
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11653202 | Other | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2936 Festival Way
Suite 409a
Waldorf, MD 20601-2957
Phone (301) 710-6919
2955 Crain Hwy
Ab
Waldorf, MD 20601-2810
Phone (301) 645-3600
3309 Forestville PL
Forestville, MD 20747-4409
Phone (301) 420-6610
5765 Burke Centre Pkwy
Suite L
Burke, VA 22015-2264
Phone (703) 250-9000
5809 Leesburg Pike
Falls Church, VA 22041-2301
Phone (866) 693-9336
9419 Lorton Market St
Lorton, VA 22079-1963
Phone (703) 339-9833
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56007024 | NY | MD | Optometrist |
| 2621 | TN | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Maryland, LLC | Optometrist | Current | Accepting new patients |
| Piedmont Access to Health Services, Inc | Current | Accepting new patients | |
| Piedmont Access to Health Services, Inc | Current | Accepting new patients | |
| Piedmont Access to Health Services, Inc | Current | Accepting new patients | |
| Myeyedr Optometry of Maryland, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Maryland, LLC | Optometrist | Current | Accepting new patients |
| Piedmont Access to Health Services, Inc | Current | Accepting new patients | |
| State of New York Comptrollers Office | Optometrist | Past | Accepting new patients |
| Silver Spring Optometry, LLC | Optometrist | Past | Accepting new patients |
| State of New York Comptrollers Office | Past | Accepting new patients |
Locations
6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206
10264 Southern Md Blvd
Ste 101
Dunkirk, MD 20754
Phone (410) 257-6931
3309 Forestville Pl
Forestville, MD 20747
Phone (301) 420-6610
19814 Century Blvd
Germantown, MD 20874
Phone (301) 540-1200
29015 Three Notch Rd
Unit 6
Mechanicsvlle, MD 20659
Phone (301) 884-4774
130 W Dares Beach Rd
Prnc Frederck, MD 20678
Phone (410) 535-2020
2955 Crain Hwy
Ste A
Waldorf, MD 20601
Phone (301) 645-3600
2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919
380 Washington St
Boydton, VA 23917
Phone (434) 738-6102
30 S Main St
Chatham, VA 24531
Phone (434) 432-4443
705 Main St
Danville, VA 24541
Phone (434) 791-4122
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 13
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.
-
dba Health Centers of the Piedmont South Boston
- Federally Qualified Health Center (FQHC)
- South Boston, VA
- NPI 1235677634
-
- Federally Qualified Health Center (FQHC)
- Danville, VA
- NPI 1649240698
-
dba PATHS Community Medical Center Danville Riverside
- Federally Qualified Health Center (FQHC)
- Danville, VA
- NPI 1114630662
-
dba Health Center of the Piedmont Martinsville
- Federally Qualified Health Center (FQHC)
- Martinsville, VA
- NPI 1841323151
-
dba Suny College of Optometry/University Eye Center
- Optometrist
- New York, NY
- NPI 1407829856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1316051055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W DARES BEACH RD",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "206783120",
"telephone_number": "410-535-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JINAKI",
"middle_name": "TAMU",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2024-11-14",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "2621",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "56007024",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA2044",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11653202",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Prince Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.