Individual provider Active NPI

Michael H Smith, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1659446110
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1117 Issued in OK
Practice address
3736 NW 50TH St
Oklahoma City, OK 73112-2554
Phone
(405) 947-1512
Fax
(405) 947-1511
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1117 OK Primary

Addresses

Primary practice location

3736 NW 50TH St
Oklahoma City, OK 73112-2554

Mailing address

3736 NW 50TH St
Oklahoma City, OK 73112-2554
Phone (405) 947-1512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20101201000682 OK Practitioner - Optometry 6103012273 Reassigns benefits to 1 organization
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1117OKMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Thomas Wolf and Associates PLLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

3431 S Boulevard
Ste 105
Edmond, OK 73013
Phone (405) 341-6941

123 N Mustang Rd
Mustang, OK 73064
Phone (405) 376-0222

12444 NW 10th St
Ste 101
Yukon, OK 73099
Phone (405) 265-7521

Organizations & group practices 1

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1659446110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122554",
            "telephone_number": "405-947-1512",
            "fax_number": "405-947-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3736 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122554",
            "telephone_number": "405-947-1512",
            "fax_number": "405-947-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.