Individual provider Active NPI

Benjamin David Smith, O.D.

  • Optometrist
  • Denver, CO
National Provider Identifier
1497909550
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2881 Issued in CO
Practice address
1041 Acoma St
Denver, CO 80204-4034
Phone
(720) 255-2412
Fax
(720) 536-8283
NPI assigned
Nov 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2881 CO Primary

Addresses

Primary practice location

1041 Acoma St
Denver, CO 80204-4034

Mailing address

1041 Acoma St
Denver, CO 80204-4034
Phone (720) 255-2412

Other identifiers 1

IdentifierTypeStateIssuer
50824066MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120731000638 CO Practitioner - Optometry 5395877302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benjamin D. Smith OD, LLCGroup PAC ID 1153549142, 2 clinicians

Practice addresses (Care Compare)

1075 Acoma St
Suite 110
Denver, CO 80204-4034
Phone (720) 255-2412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Eye Associates PLLC Optometrist CurrentSince Sep 1, 2013 Accepting new patients
Benjamin D. Smith OD, LLC Optometrist CurrentSince Apr 14, 2014 Accepting new patients
Benjamin D Smith OD LLC Optometrist PastSince Apr 14, 2014 Accepting new patients
Optometric Associates PC Optometrist Past Accepting new patients

Locations

15901 E Briarwood Cir
Unit 100
Aurora, CO 80016
Phone (303) 662-8400

1041 Acoma St
#C
Denver, CO 80204
Phone (303) 995-3393

1041 Acoma St
Denver, CO 80204
Phone (303) 995-3393

1075 Acoma St
Ste 110
Denver, CO 80204
Phone (720) 255-2412

Organizations & group practices 4

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": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1497909550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 ACOMA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044034",
            "telephone_number": "720-255-2412",
            "fax_number": "720-536-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 ACOMA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044034",
            "telephone_number": "720-255-2412",
            "fax_number": "720-536-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-14",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50824066",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.