Individual provider Active NPI

Jinaki Tamu Smith, O.D.

  • Optometrist
  • Prince Frederick, MD
National Provider Identifier
1316051055
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2044 Issued in MD
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

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
11653202OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20091105000145 MD Practitioner - Optometry 0840299574 Reassigns benefits to 1 organization
I20230223002423 VA Practitioner - Optometry 0840299574 Reassigns benefits to 3 organizations
I20241130000224 DC Practitioner - Optometry 0840299574 Reassigns benefits to 2 organizations

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
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

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

LicenseStateTypeSpecialty
56007024NYMDOptometrist
2621TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew 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 CurrentSince Feb 1, 2023 Accepting new patients
Piedmont Access to Health Services, Inc CurrentSince Feb 1, 2023 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Nov 13, 2024 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Dec 21, 2025 Accepting new patients
Piedmont Access to Health Services, Inc CurrentSince Feb 1, 2023 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.

View all 13

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

Verify at the official NPI Registry.