Jeffrey Alan Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1612 Issued in KS

Practice address

18325 N Allied Way Ste 100
Phoenix, AZ 85054

Phone

(602) 467-4966

Fax

(480) 419-5401

NPI assigned

Aug 23, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Illinois College of Optometry at Chicago, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brandon Suedekum MD, PCGroup PAC ID 3779915558, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brandon Suedekum MD, PC

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1487204442
  Medicare reassignment Care Compare group
• Millennium Vision Inc

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1184730251

  Optometrist

  NPD
• University of Miami

  • Ophthalmology Physician
  • Miami, FL
  • NPI 1073550398
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1609869981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543106",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2208",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03157",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY",
            "identifier": "2208",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410049327",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Michael Smith, CPHT
• Jasmine Rose Smith, FNP-C
• Javon Smith
• Jayla Smith
• Jeanette M Smith, PHD
• Jennifer Smith, RBT
• Jennifer Lynn Smith, NMD
• Jessica Anne Smith
• Jessica Walker Smith, MS, CPNP
• Josh J Smith, PSYD

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.