Brian Darrell Smith, O.D.

Individual provider Active NPI Optometrist · Milltown, WI

NPI 1366483612 · NPPES record last updated Jul 7, 2009

Key facts

NPI
1366483612
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2728 (WI)
Practice address
1301 County Road G
Milltown, WI 54858-2915
Phone
(715) 825-3974
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 9

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Southern College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siren Family Eyecare LLC (2 clinicians)
Osceola Family Eyecare LLC (2 clinicians)
St. Croix Tribal Council (7 clinicians)

Practice addresses (Care Compare)

24082 State Rd
Suite 35
Siren, WI 54872-4451
Phone (715) 349-2733

304 3Rd Ave E
Osceola, WI 54020-8185
Phone (715) 294-2500

4404 State Rd
Suite 70
Webster, WI 54893-9251
Phone (715) 349-8554

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040330000742 WI Practitioner - Optometry 7719979046 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Family Eyecare LLC Optometrist Current
since Jan 29, 2011
Accepting new patients
Siren Family Eyecare, LLC Optometrist Current
since Jun 1, 2007
Accepting new patients
St. Croix Tribal Council Current
since Sep 15, 2004
Accepting new patients
Javen D. Holm OD PA Optometrist Past Accepting new patients
St. Croix Tribal Council Past Accepting new patients
Eyecare Center Optometrist PSC Optometrist Past Accepting new patients
Rice Lake Family Eyecare, LLC Optometrist Past Accepting new patients
Eyecare Center Optometrist PSC Optometrist Past Accepting new patients
Smith Vision Center, Optometrists LLC Optometrist Past Accepting new patients

Locations

2221 60th St
Luck, WI 54853
Phone (715) 857-5694

304 3rd Ave
Osceola, WI 54020
Phone (715) 294-2500

24082 State Road 35
Siren, WI 54872
Phone (715) 294-2500

4404 State Road 70
Webster, WI 54893
Phone (715) 349-8554

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2728 WI Yes

Addresses

Primary practice location

1301 County Road G
Milltown, WI 54858-2915

Mailing address

1301 County Road G
Milltown, WI 54858-2915
Phone (715) 825-3974

Other providers in Milltown, WI

All providers in Milltown, WI · Optometrist in Wisconsin

Sources for this page

Verify at the official NPI Registry.