Justin Bradley Smith, O.D.

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

4654 Issued in MA

Practice address

330 Baker Ave
Concord, MA 01742-2129

Phone

(978) 287-9494

Fax

(978) 287-9404

NPI assigned

Mar 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

New England College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmithod20585@direct.atrius.masshiway.net

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914

  Optometrist

  Medicare reassignment Care Compare group NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1114265634
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1740238526
  NPD (past)

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

{
    "created_epoch": "1204934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1437329190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9494",
            "fax_number": "978-287-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BAKER AVE",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422129",
            "telephone_number": "978-287-9494",
            "fax_number": "978-287-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-08",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4654",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MA",
            "license": "4654",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "4654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0729787",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmithod20585@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "330 Baker Ave",
            "city": "Concord",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017422129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Sloan
• Lily Rachel Slosky, CCC-SLP
• Kathryn R Small, NP
• Brenda L. Smith, MSW
• Jennifer L. Smith, APRN
• Kellie J Smith, MS, ATC
• Maria Viola Smith, MD
• Stephen Anthony Smith, M.D.
• Alexander Smoolca, MA
• Sophie Smyke, LCSW

• Pediatric Optometrist in Concord, MA
• Providers in Concord, MA by specialty
• Pediatric Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.