Individual provider Active NPI

Tiffany Tyler Smart, OD

  • Optometrist
  • Morro Bay, CA
National Provider Identifier
1619948304
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12647 Issued in CA
Practice address
590 Harbor St
Morro Bay, CA 93442-1904
Phone
(805) 772-1269
Fax
(805) 772-2172
NPI assigned
Jan 30, 2006
Last updated
Jan 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12647 CA Primary

Addresses

Primary practice location

590 Harbor St
Morro Bay, CA 93442-1904

Mailing address

590 Harbor St
Morro Bay, CA 93442-1904
Phone (805) 772-1269

Other identifiers 1

IdentifierTypeStateIssuer
SD01264701MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070627000456 CA Practitioner - Optometry 6204935588 Reassigns benefits to 2 organizations
Practice locations: Morro Bay, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

425 W Central Ave
Suite 102
Lompoc, CA 93436-2806
Phone (805) 736-2020

437 Marsh St
San Luis Obispo, CA 93401-3822
Phone (805) 925-2637

590 Harbor St
Morro Bay, CA 93442-1904
Phone (805) 772-1269

689 Tank Farm Rd
Suite 100
San Luis Obispo, CA 93401-7078
Phone (805) 781-3937

910 E Stowell Rd
Santa Maria, CA 93454-7001
Phone (805) 925-2637

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
97.86
Improvement activities
40
Cost
75.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12647CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Eyecare Medical Group a Medical Corporation Optometrist CurrentSince Mar 1, 2022 Accepting new patients
San Luis Obispo Eye Associates, a Medical Group Inc Optometrist Current Accepting new patients
Elite Eyecare Medical Group a Medical Corporation Optometrist Current Accepting new patients
San Luis Obispo Eye Associates, a Medical Group Incorporated Optometrist CurrentSince Aug 11, 2025 Accepting new patients
Elite Eyecare Medical Group a Medical Corporation CurrentSince Mar 1, 2022 Accepting new patients

Locations

425 W Central Ave
Ste 102
Lompoc, CA 93436
Phone (805) 736-2020

590 Harbor St
Morro Bay, CA 93442
Phone (805) 772-1269

910 E Stowell Rd
Santa Maria, CA 93454
Phone (805) 925-2637

689 Tank Farm Rd
Ste 100
Sn Luis Obisp, CA 93401
Phone (805) 781-3637

234 Heather Ct
Ste 102
Templeton, CA 93465
Phone (805) 434-5970

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tiffany.smart@direct.shepardeye.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1619948304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 HARBOR ST",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934421904",
            "telephone_number": "805-772-1269",
            "fax_number": "805-772-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 HARBOR ST",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934421904",
            "telephone_number": "805-772-1269",
            "fax_number": "805-772-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "TIFFANY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD01264701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morro Bay, CA

Sources for this page

Verify at the official NPI Registry.